SAFECOM Membership Questionnaire

ICR 202105-1670-001

OMB:

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supplementary Document
2021-05-07
Supporting Statement B
2021-05-07
Supporting Statement A
2021-05-07
IC Document Collections
IC ID
Document
Title
Status
247241 New
ICR Details
202105-1670-001
Received in OIRA
DHS/CISA
SAFECOM Membership Questionnaire
New collection (Request for a new OMB Control Number)   No
Regular 06/09/2021
  Requested Previously Approved
36 Months From Approved
50 0
13 0
625 0

The SAFECOM Membership Questionnaire is an internal SAFECOM document disseminated only to active SAFECOM Members. SAFECOM uses the Questionnaire to identify membership gaps, obtain updated information on SAFECOM’s membership body (e.g., public safety communications experience, accolades, acquired skills/certifications, etc.), update SAFECOM marketing materials, and to assist SAFECOM when responding General Accounting Office (GAO) inquiries. The Questionnaire will encompass eight interdependent sections of questions. The SAFECOM Internal Membership section requests each Member to provide their name, state of residence, and the number of hours per month he/she contributes SAFECOM led initiatives (e.g., conference calls and deliverable development). SAFECOM consists of public safety association representatives and at-large members. The Association Representative Information section pertains to public safety associations represented in SAFECOM. Association Representatives serving in SAFECOM are asked to provide the name of their Association, approximate Association size, Association contact, and addition Association point-of-contact (POC) information. At-large members are instructed to skip to the next section. Public Safety Service section will focus on questions related to each Member’s public safety and first responder career. Members are asked to designate their current public safety status (i.e., active, retired, other), to identify their public safety discipline(s), to provide level of government for current employment (e.g., state, local, tribal, territorial, federal), to provide years of service, to list current agency and agency’s contact information, to provide a brief description on their current role and responsibilities, to select the population range that best describes the population of your current organization’s jurisdiction serviced, to indicate the number of public safety personnel employed at your current organization, to indicate the number of responses your current organization responds to each year, and if current position entails collaborating with Tribal Nations. The Volunteer Experience section asks Members to provide details on their volunteer experience. The Public Safety Experience section asks Members to identify the public safety events he/she responded to throughout their career, and to identify the communications technology he/she has used. The Education section focuses on the education (e.g., which is an optional question), proficiencies, and professional certifications. External Conference Attendance section focuses on Member’s experience at public safety conferences as well as their interest in representing SAFECOM in the future at a conference. The final section focuses on Members public safety usage.

PL: Pub.L. 104 - 13 3501 Name of Law: Paperwork Reduction Act, 1995
   PL: Pub.L. 115 - 278 2201 Name of Law: Homeland Security Act of 2002
   US Code: 6 USC 571 Name of Law: Office of Emergency Communications
   US Code: 6 USC 652 Name of Law: Cybersecurity and Infrastructure Agency
   PL: Pub.L. 107 - 296 101 Name of Law: Homeland Security Act, 2002
   PL: Pub.L. 109 - 295 1801 Name of Law: Department of Homeland Security Appropriations Act, 2007
  
None

Not associated with rulemaking

  85 FR 60483 09/25/2020
86 FR 15488 03/23/2021
Yes

1
IC Title Form No. Form Name
SAFECOM Membership Questionnaire 1670-00XX SAFECOM Membership Questionnaire

  Total Request 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 50 0 0 50 0 0
Annual Time Burden (Hours) 13 0 0 13 0 0
Annual Cost Burden (Dollars) 625 0 0 625 0 0
Yes
Miscellaneous Actions
No
This is a NEW collection

$984
Yes Part B of Supporting Statement
    Yes
    Yes
No
No
No
No
Mia Bruce 202 357-8441 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/09/2021


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