Certification Form

UNITED STATES DEPARTMENT OF EDUCATION
OFFICE OF MANAGEMENT
OFFICE OF CHIEF PRIVACY OFFICER
CERTIFICATION FOR PAPERWORK REDUCTION ACT SUBMISSIONS
SUBMISSION INFORMATION
On behalf of this Federal Agency, I certify that collection of information encompassed by this request complies with 5 CFR 1320.9 and related
provisions of 5 CFR 1320.8(b)(3).
ICR Title U.S. Department of Education Grant Performance Report Form (ED 524B)
OMB#

1894-0003

Docket ID# (for office use only)

The following topics summarize the proposed information collection that certification covers. By signing below, you are certifying your
Principal Office's compliance. If you are unable to certify any of these provisions, please identify and explain the reason in number 18 of your
accompanying Supporting Statement:
✔

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)
(ii)
(iii)
(iv)
(v)
(vi)

Why the information is being collected;
Use of information;
Burden estimate;
Nature of response (voluntary, required for a benefit, or mandatory);
Nature and extent of confidentiality; and
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);

✔

J.

It makes appropriate use of information technology; and

✔

K. It reflects appropriate input from all agency offices, such as OPEPD and OGC, affected by and involved with collecting the
required data from the public. POs must ensure all policy issues are addressed prior to submittals (for example, any policy
issues with grant applications) so the ICR is ready for public view.

Your office must certify approval of all submitted information collection requests. Your signature authorizes OCPO to post the
information collection request for public comment. If this collection should not be publicly available, please provide reasons to OCPO via
e-mail to [email protected] with your official submittal. OCPO does not share Information collections tied to a proposed or draft rule
with the public until the publication date of that rule.
Digital Signature of Principal Office Official or Designee
Exp. 4/30/2016

Alfreida Pettiford

Digitally signed by Alfreida Pettiford
DN: c=US, o=U.S. Government, ou=U.S. Department of Education, cn=Alfreida Pettiford,
0.9.2342.19200300.100.1.1=9268273580
Date: 2017.02.13 15:43:46 -05'00'

ED 162