Camp Lejeune Drinking Water Notification Registry

Forms and Documents

Document Name	Status
0703-0057_PIA_12.6.2019.pdf Supplementary Document	2019-12-19
0703-0057_SS-A_12.06.19.docx Supporting Statement A	2019-12-19

IC Document Collections

IC ID	Document Title	Status
185160	Camp Lejeune Drinking Water Notification Registry Other-Website Screenshots	Modified

ICR Details

OMB Control No: 0703-0057	ICR Reference No: 201912-0703-003
Status: Active	Previous ICR Reference No: 201610-0703-002
Agency/Subagency: DOD/NAVY	Agency Tracking No:
Title: Camp Lejeune Drinking Water Notification Registry
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: 02/28/2020
	Date Received in OIRA: 12/20/2019
Terms of Clearance: In accordance with 5 CFR 1320, the information collection is approved for three years.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2023	36 Months From Approved	02/29/2020
Responses	10,000	0	10,000
Time Burden (Hours)	1,000	0	1,000
Cost Burden (Dollars)	23,230	0	23,230

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Abstract: The information collected will be used to obtain information as well as some limited historical data of people who may have been exposed to contaminated drinking water aboard Marine Corps Base Camp Lejeune, NC. The collection is voluntary and will be accomplished through an online registry, or respondents may use a toll-free call line to register over the phone with assistance of a trained representative. The information will be used to notify and provide information related to the historic drinking water issue.

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Authorizing Statute(s): PL: Pub.L. 110 - 181 315 Name of Law: null
  

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 41977	08/16/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 69732	12/19/2019
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
Camp Lejeune Drinking Water Notification Registry

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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	10,000	10,000	0	0	0	0
Annual Time Burden (Hours)	1,000	1,000	0	0	0	0
Annual Cost Burden (Dollars)	23,230	23,230	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: $996,158

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.     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

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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: 12/20/2019

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