FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES

Forms and Documents

Document	Type	Status	Availability
Form OSC FORM-14 FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES	Form and Instruction	Removed	Repair queued
USOSC Form 14 PROD v3.2 (003).pdf	Supporting Statement B	Uploaded 2017-09-15	Available
Form 14 PPRA Supporting Statement (Final).pdf	Supporting Statement A	Uploaded 2017-06-07	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
236887	Form 14: Electronic Submission of Allegations and Disclosures		New
223438	FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES	Form and Instruction	Removed

ICR Details

OMB Control No: 3255-0005	ICR Reference No: 201907-3255-001
Status: Historical Inactive	Previous ICR Reference No: 201706-3255-001
Agency/Subagency: OSC	Agency Tracking No: OSC FORM-14
Title: FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 07/22/2019
OIRA Conclusion Action: Improperly submitted and continue	Conclusion Date: 07/16/2019
	Date Received in OIRA: 07/12/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2020	6 Months From Approved	09/30/2020
Responses	6,000	0	6,000
Time Burden (Hours)	6,917	0	6,917
Cost Burden (Dollars)	0	0	0

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Abstract: The previous version of this form was approved by OMB/OIRA to replace forms OSC-11, OSC-12, AND OSC-13, which were also previously approved by OMB. This updated electronic form will be used by current and former federal employees and applicants for federal employment, and other covered filers, to submit allegations of possible prohibited personnel practices or other prohibited activities for investigation and possible prosecution by OSC, or review and possible referral to relevant inspector general offices.

Emergency Justfication: Pursuant to 5 C.F.R. § 1320.13, OSC requests OMB authorize emergency processing of OSC’s updated Form 14, which will permit the electronic filing of complaints and disclosures with OSC. OSC has determined that using a new electronic filing form for complaints and disclosures is necessary to integrate submissions with OSC’s new electronic case management system (eCMS). OSC’s eCMS becomes operative on August 12, 2019. Congress has mandated that all agencies move to electronic records, and the submission of complaints through Form 14 is essential to OSC’s compliance with that mandate and its ability to fulfill its mission. The contracts with the vendors who are migrating OSC to eCMS and who manage transferring the data from the dynamic Form 14 into OSC’s eCMS are expiring at the end of the fiscal year. Thus, OSC needs to implement Form 14 by mid-August to allow time for the contractors to fix any issues that arise with implementation. OSC has previously received OMB approval of Form 14 (OMB Control # 3255-0005), and, accordingly has already provided stakeholders with the requisite notice. The updated Form 14 does not increase the burden on other agencies or members of the public. The substantive updates to Form 14 reflect statutory changes. Congress authorized whistleblowers to disclose to OSC “censorship related to scientific research” in the Whistleblower Protection Enhancement Act of 2012. And Congress amended 5.U.S.C. § 2302(b) to add a prohibited personnel practice (“(14) access the medical record of another employee or an applicant for employment as a part of, or otherwise in furtherance of, any conduct described in paragraphs (1) through (13).”). Accordingly, OSC does not have discretion to omit these bases for complaints from Form 14.

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Authorizing Statute(s): US Code: 5 USC 1212 Name of Law: Powers and Functions of the Office of Special Counsel
   US Code: 5 USC CFR 1800 Name of Law: Filing of Complaints and Allegations
  

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

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
FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES	OSC FORM-14, OSC FORM-14	FORM 14: ELECTRONIC SUBMISSION OF ALLEGATIONS AND DISCLOSURES
Form 14: Electronic Submission of Allegations and Disclosures

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This updated electronic form will be used by current and former federal employees and applicants for federal employment, and other covered filers, to submit allegations of possible prohibited personnel practices or other prohibited activities for investigation and possible prosecution by OSC, or review and possible referral to relevant inspector general offices.

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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: 07/12/2019

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