Application Form for Membership on the Community Advisory Council

Forms and Documents

Document Name	Status
Form FR 1401 Application Form for Membership on the Community Advisory Council Form and Instruction	Unchanged
FR1401_20190528_omb.pdf Supporting Statement A	2019-05-28

IC Document Collections

IC ID	Document Title	Status
220561	Application Form for Membership on the Community Advisory Council Form and Instruction	Unchanged

ICR Details

OMB Control No: 7100-0371	ICR Reference No: 201905-7100-006
Status: Active	Previous ICR Reference No: 201812-7100-004
Agency/Subagency: FRS	Agency Tracking No: FR 1401
Title: Application Form for Membership on the Community Advisory Council
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Delegated
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/28/2019
	Date Received in OIRA: 05/28/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2022	36 Months From Approved	05/31/2019
Responses	314	0	314
Time Burden (Hours)	314	0	314
Cost Burden (Dollars)	0	0	0

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Abstract: The Application Form for Membership on the Community Advisory Council (Application) is used to obtain information about the experience and qualification of persons seeking to be considered for membership on the Community Advisory Council of the Board (CAC). The Application collects an applicant’s contact information; details regarding current employment and areas of expertise; a resume, which typically includes information about employment history, education, and training; and a cover letter explaining why the applicant is interested in serving on the CAC and what he or she believes are their primary qualifications. Applicants can voluntarily elect to provide additional information to support their application.

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Authorizing Statute(s): US Code: 12 USC 225a Name of Law: Federal Reserve Act
   US Code: 12 USC 244 Name of Law: Federal Reserve Act
  

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:
	84 FR 718	01/31/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 23567	05/22/2019
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Application Form for Membership on the Community Advisory Council	FR 1401	Application Form for Membership on the Community Advisory Council

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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	314	314	0	0	0	0
Annual Time Burden (Hours)	314	314	0	0	0	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:

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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: 05/28/2019

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