PROSPECT QUESTIONNAIRE, CHAT NOW QUESTIONNAIRE, AND THE OFFICER PROGRAM APPLICATION

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form CGRC-1130 (01/17) Prospect Questionnaire, Officer Program Application, and Chat Now Questionnaire	Form and Instruction	New	Available
1625-New_30-Day FR Notice_82FR 49039_20171023.doc	Supplementary Document	Uploaded 2018-05-17	Available
1625-NEW_60-Day FR Notice_82 FR 33140_20170719.doc	Supplementary Document	Uploaded 2018-05-17	Available
PTA, USCG - United States Coast Guard “Chat Now” Questionnaire, 20170331, PRIV Final.pdf	Supplementary Document	Uploaded 2018-05-17	Available
PTA, USCG - United States Coast Guard Officer Program Application, 20170331, PRIV Final.pdf	Supplementary Document	Uploaded 2018-05-17	Available
PTA, USCG - United States Coast Guard Prospect Questionnaire, 20170331, PRIV Final.pdf	Supplementary Document	Uploaded 2018-05-17	Available
DHS_USCG_014 Military Pay_Personnel SORN_20111028.pdf	Supplementary Document	Uploaded 2018-05-17	Available
privacy-pia-uscg-024 direct access-november2016.pdf	Supplementary Document	Uploaded 2018-05-17	Available
USCODE-2012-title14-partI-chap13-sec468.pdf	Supplementary Document	Uploaded 2018-05-17	Available
USCODE-2011-title10-subtitleA-partII-chap31-sec503.pdf	Supplementary Document	Uploaded 2018-05-17	Available
1625-new_SS_r2_2018.doc	Supporting Statement A	Uploaded 2018-05-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
231490	Prospect Questionnaire, Officer Program Application, and Chat Now Questionnaire	Form and Instruction	New

ICR Details

OMB Control No: 1625-0128	ICR Reference No: 201805-1625-003
Status: Active	Previous ICR Reference No:
Agency/Subagency: DHS/USCG	Agency Tracking No:
Title: PROSPECT QUESTIONNAIRE, CHAT NOW QUESTIONNAIRE, AND THE OFFICER PROGRAM APPLICATION
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/17/2019
	Date Received in OIRA: 06/04/2018
Terms of Clearance: The Coast Guard has been given two years approval for this collection. The agency will not receive a three year approval until it demonstrates an ability to track its collections and keep them from falling out of compliance. The USCG will also ensure that it continues to comply with OMB guidance regarding the tracking of individuals across websites through advertisements.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	36 Months From Approved
Responses	50,000	0	0
Time Burden (Hours)	25,000	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Approximately 50,000 prospects and/or centers of influence visit US Coast Guard recruiting website gocoastguard.com for information about US Coast Guard enlisted and officer opportunities. The Coast Guard uses the information from applicants completing the these forms to conduct initial screenings on their eligibility.

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Authorizing Statute(s): US Code: 10 USC 503 Name of Law: Enlistments: Recruiting Campaignes; Compilation of Directory Information
   US Code: 14 USC 468 Name of Law: Procurment of Personnel
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 33140	07/19/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 49039	10/23/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Prospect Questionnaire, Officer Program Application, and Chat Now Questionnaire	CGRC-1130 (01/17), CGRC-1131 (02/17), CGRC-1132 (02/17)	USCG Prospect Questionnaire ,   USCG Officer Program Applicatoin ,   USCG "Chat Now" Questionnaire

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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	50,000	0	0	0	50,000	0
Annual Time Burden (Hours)	25,000	0	0	0	25,000	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: This is an existing collection in use without an OMB control number.

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Annual Cost to Federal Government: $0

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.     Yes

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.     Yes

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: 06/04/2018

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