Personal Information Form

Forms and Documents

Document Name	Status
Form OPIC-129 Personal Information Form Form and Instruction	New
OPIC Form 129 - Justification - Supporting Statement.doc Supporting Statement A	2018-07-11
OPIC-129 - blackline(2018).docx Supplementary Document	2018-07-11

IC Document Collections

IC ID	Document Title	Status
232144	Personal Information Form Form and Instruction	New

ICR Details

OMB Control No: 3420-0018	ICR Reference No: 201807-3420-001
Status: Active	Previous ICR Reference No: 201704-3420-001
Agency/Subagency: OPIC	Agency Tracking No: OPIC-129
Title: Personal Information Form
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: 07/11/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2021	36 Months From Approved	10/31/2018
Responses	500	0	630
Time Burden (Hours)	500	0	1,890
Cost Burden (Dollars)	37,500	0	141,750

---

Abstract: The information provided in the OPIC-129 is used by OPIC as a part of the Character Risk Due Diligence/background check procedure (similar to a commercial bank's Know Your Customer procedure) that it performs on each party that has a significant relationship (10% or more beneficial ownership, provision of significant credit support, significant managerial relationship) to the projects that OPIC finances.

---

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

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 19577	05/03/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 32157	07/11/2018
Did the Agency receive public comments on this ICR? Yes

---

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

IC Title	Form No.	Form Name
Personal Information Form	OPIC-129	Personal Information Form

---

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	500	630	0	-130	0	0
Annual Time Burden (Hours)	500	1,890	0	-1,390	0	0
Annual Cost Burden (Dollars)	37,500	141,750	0	-104,250	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 revised form will make OPIC's due diligence process more efficient and less resource intensive without significantly increasing the reputational and project risks associated with OPIC transactions. These efficiencies have resulted in a greatly reduced estimated burden for both the completion and the review of the form. Since the last renewal, OPIC has developed the capability to precisely track the number of applications that it receives. The projected estimate, which is lower than previously estimated, is based on figures from the past three years and includes all of OPIC"s business lines.

---

Annual Cost to Federal Government: $27,455

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

---

Common Form ICR:  No

---

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: 07/11/2018

---