Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants & Awardees

Forms and Documents

Document Name	Status
0505-0025 Generic Renewal Final SuptStmt 042919.docx Supporting Statement A	2019-04-29
Copy of Appendix A (OMB No. 0505-0025) (2).xlsx Supplementary Document	2019-04-29
Copy of 0505-0025 - Burden Spreadsheet -Final.xlsm 2019.xlsm Supplementary Document	2019-04-29
AD-3031 Section 508 Compliant.pdf 2019.pdf Supplementary Document	2019-04-29
AD-3030 Section 508 Compliant.pdf 2019.pdf Supplementary Document	2019-04-29

IC Document Collections

IC ID	Document Title	Status

ICR Details

OMB Control No: 0505-0025	ICR Reference No: 201904-0505-002
Status: Historical Active	Previous ICR Reference No: 201609-0505-001
Agency/Subagency: USDA/OCFO	Agency Tracking No:
Title: Representations Regarding Felony Conviction and Tax Delinquent Status for Corporate Applicants & Awardees
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: 06/11/2019
	Date Received in OIRA: 04/29/2019
Terms of Clearance: If this ICR is renewed, the program will need to explain if the General Services Administration’s System for Award Management is operational, and if so, why the program is still collecting this information.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2022	36 Months From Approved	06/30/2019
Responses	969,438	0	2,256,097
Time Burden (Hours)	242,360	0	564,024
Cost Burden (Dollars)	0	0	0

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Abstract: Information collected will be used to evaluate corporate applicants and awardees felony conviction and tax delinquency status prior to entering into new non-procurement contracts, grants, loans, loan guarantees, cooperative agreements and some memoranda of agreement. The information is needed to ensure fiscal year funds are not inappropriately disbursed.

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Authorizing Statute(s): PL: Pub.L. 116 - 6 744 and 745 Name of Law: Consolidated Appropriations Act, 2019
  

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 62833	12/06/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 17996	04/29/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 0

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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	969,438	2,256,097	0	0	-1,286,659	0
Annual Time Burden (Hours)	242,360	564,024	0	0	-321,664	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: The decrease in the number of respondents, responses and burden hours is due to a miscalculation in the previous renewal request.

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Annual Cost to Federal Government:

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.     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: 04/29/2019

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