Flight Analog Projects (FAP) Crew Selection Questionnaire

Forms and Documents

Document Name	Status
Supporting Statement A Flight Analog Projects Crew Selection Questionnaire.docx Supporting Statement A	2020-02-12

IC Document Collections

IC ID	Document Title	Status
237956	Flight Analog Projects (FAP) Crew Selection Questionnaire Other-Questionnaire	New

ICR Details

OMB Control No: 2700-0174	ICR Reference No: 201909-2700-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: NASA	Agency Tracking No:
Title: Flight Analog Projects (FAP) Crew Selection Questionnaire
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/20/2020
	Date Received in OIRA: 10/02/2019
Terms of Clearance: This collection is approved based on the revised materials provided by the Agency.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2023	36 Months From Approved
Responses	100	0	0
Time Burden (Hours)	33	0	0
Cost Burden (Dollars)	955	0	0

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Abstract: The NASA Human Research Program (HRP) is responsible for understanding and mitigating the highest risks to astronaut health and performance to ensure that crews remain healthy and productive during long-duration missions beyond low Earth orbit. As NASA prepares to conduct crewed missions in cis-lunar space, on the Moon, and eventually at other locations including MARS, HRP biomedical research and technological development are enabling the Agency to safely send humans into deep space for longer durations. This collection will help to select subjects for the Analog missions for these ground studies and provide opportunities to have wide variety of subject pool.

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Authorizing Statute(s): None

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 104	05/30/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 191	10/02/2019
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
Flight Analog Projects (FAP) Crew Selection Questionnaire

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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	100	0	0	100	0	0
Annual Time Burden (Hours)	33	0	0	33	0	0
Annual Cost Burden (Dollars)	955	0	0	955	0	0

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 is a new ICR and a new IC. The burden is increasing from zero because this questionnaire did not previously exist.

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Annual Cost to Federal Government: $502

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: 10/02/2019

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