Application for Political Risk Insurance

Forms and Documents

Document	Type	Status	Availability
Form 52 Application for Political Risk Investment Insurance	Form and Instruction	Modified	Available
Form 52 Blackline (05-21-18).docx	Supplementary Document	Uploaded 2018-05-30	Available
form 52 supporting stmt.docx	Supporting Statement A	Uploaded 2018-05-30	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
35913	Application for Political Risk Investment Insurance	Form and Instruction	Modified

ICR Details

OMB Control No: 3420-0011	ICR Reference No: 201805-3420-001
Status: Active	Previous ICR Reference No: 201610-3420-001
Agency/Subagency: OPIC	Agency Tracking No: OPIC-52
Title: Application for Political Risk Insurance
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/13/2018
	Date Received in OIRA: 05/30/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2021	36 Months From Approved	08/31/2018
Responses	45	0	100
Time Burden (Hours)	135	0	900
Cost Burden (Dollars)	10,125	0	67,500

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Abstract: The Application is the principal document used by OPIC to determine the investor's and the project's eligibility for political risk insurance and to collect information for underwriting analysis.

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Authorizing Statute(s): US Code: 22 USC 231, 234(a), 239(d) 240(a) Name of Law: Foreign Assitance Act of 1961
  

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:
	83 FR 9879	03/08/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 24516	05/29/2018
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Application for Political Risk Investment Insurance	52	Application for Political Risk Insurance

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ICR Summary 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	45	100	0	-55	0	0
Annual Time Burden (Hours)	135	900	0	-765	0	0
Annual Cost Burden (Dollars)	10,125	67,500	0	-57,375	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The total number of submissions is decreased to more accurately reflect the estimated number of forms received. The amount of time it takes to complete the Form 52 is less than previously reported, which leads to a reduction in the burden on the public. Due to the decreased number of submissions, the overall federal government burden for the Form 52 has reduced. However, the average time for the government to review the Form 52 remains unchanged.

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Annual Cost to Federal Government: $4,941

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: 05/30/2018

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