HIRE Vets Medallion Program, Program Demonstration

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form VETS-1011MP HIRE VETS - Program Demonstration	Form and Instruction	New	Available
Form VETS-1011LG HIRE Vets Medallion Program	Form and Instruction	Modified	Available
1293-0015_HIRE Supporting Statement fINAL 2017-11-13.docx	Supporting Statement A	Uploaded 2017-11-13	Available
Consolidated Appropriations Act, 2017.pdf	Supplementary Document	Uploaded 2017-08-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
228840	HIRE VETS - Program Demonstration	Form and Instruction	New
227842	HIRE Vets Medallion Program	Form and Instruction	Modified

ICR Details

OMB Control No: 1293-0015	ICR Reference No: 201710-1293-002
Status: Historical Active	Previous ICR Reference No: 201707-1293-001
Agency/Subagency: DOL/ASVET	Agency Tracking No: 1293-0015(2017)
Title: HIRE Vets Medallion Program, Program Demonstration
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/09/2018
	Date Received in OIRA: 11/13/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2021	36 Months From Approved
Responses	35,179	0	0
Time Burden (Hours)	60,436	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Department of Labor published Final regulations implementing the Honoring Investments Recruiting and Employing (HIRE) American Military Act of 2017 (the Act). The HIRE Vets Act requires the Department to annually solicit and accept voluntary information from employers for consideration of employers to receive a HIRE Vets Medallion Award. The Act establishes specific criteria for large employers and allows the Department discretion in establishing additional criteria for each large employer award level and criteria for small and medium employers to qualify for similar awards. The Final establishes the application process and criteria that the Department intends to use to receive, review, and process applications to verify the information provided; and award the HIRE VETS Medallion. VETS will conduct a system test of the web-based application process in 2018, the HIRE Vets Medallion Program Demonstration, (“Program Demonstration”). VETS plans to limit the number of applicants to 300 for awards to be made on or about Veteran’s Day 2018.

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Authorizing Statute(s): US Code: 38 USC 4102 Name of Law: Veterans' Benefits
   PL: Pub.L. 115 - 31 Division 0 Name of Law: Consolidated Appropriations Act, 2017
  

Citations for New Statutory Requirements: PL: Pub.L. 115 - 31 Division O Name of Law: Consolidated Appropriations Act, 2017

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1293-AA21	Final or interim final rulemaking	82 FR 52186	11/13/2017

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 39460	08/18/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 39371	08/18/2017
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
HIRE VETS - Program Demonstration	VETS-1011MG, VETS-1011LG, VETS-1011MP, VETS-1011SG, VETS-1011SG, VETS-1011SP, VETS-1011SP, VETS-1011LG, VETS-1011LP, VETS-1011LP, VETS-1011MG, VETS-1011MP	2018 HIRE VETS Application Medium Employer Platinum (Screenshots) ,   2018 HIRE VETS Application Medium Employer Gold (Screenshots) ,   2018 HIRE VETS Application Large Employer Gold (Screenshots) ,   HIRE Vets Medallion Award Application Large Employer Gold ,   2018 HIRE VETS Application Large Employer Platinum (Screenshots) ,   HIRE Vets Medallion Award Application Large Employer Platinum ,   HIRE Vets Medallion Award Application Medium Employer Gold Award ,   HIRE Vets Medallion Award Application Medium Employer Platinum ,   2018 HIRE VETS Application Small Employer Gold (Screenshots) ,   HIRE Vets Medallion Award Application Small Employer Gold ,   2018 HIRE VETS Application Small Employer Platinum (Screenshots) ,   HIRE Vets Medallion Award Application Small Employer Platinum
HIRE Vets Medallion Program	VETS-1011MP, VETS-1011SG, VETS-1011SG, VETS-1011SP, VETS-1011SP, VETS-1011LP, VETS-1011LP, VETS-1011MG, VETS-1011MG, VETS-1011MP, VETS-1011LG, VETS-1011LG	2018 HIRE VETS Application Large Employer Gold (Screenshots) ,   2018 HIRE VETS Application Large Employer Platinum (Screenshots) ,   HIRE Vets Medallion Award Application Large Employer Platinum ,   2018 HIRE VETS Application Medium Employer Gold (Screenshots) ,   HIRE Vets Medallion Award Application Medium Employer Gold ,   HIRE Vets Medallion Award Application Large Employer Gold ,   2018 HIRE VETS Application Medium Employer Platinum Gold (Screenshots) ,   HIRE Vets Medallion Award Application Medium Employer Platinum ,   2018 HIRE VETS Application Small Employer Gold (Screenshots) ,   HIRE Vets Medallion Award Application Small Employer, Gold ,   2018 HIRE VETS Application Small Employer Platinum (Screenshots) ,   HIRE Vets Medallion Award Application Small Employer - Platinum

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	35,179	0	34,711	468	0	0
Annual Time Burden (Hours)	60,436	0	59,571	865	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Department is requesting OMB approval for the new collections of information contained in the Final Rule implementing the Honoring Investments in Recruiting and Employing American Military Veterans Act of 2017 (HIRE Vets Act of 2017). The Department is requesting OMB approval for the one-time Program Demonstration. Applicants do not need to pay a fee to participate in the Program Demonstration.

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Annual Cost to Federal Government: $933,099

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/13/2017

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