Financial History Questionnaire

ICR 202107-1140-001

OMB:

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
New
Supplementary Document
2021-07-21
Supplementary Document
2021-07-21
Supporting Statement A
2021-07-21
IC Document Collections
IC ID
Document
Title
Status
248470 New
ICR Details
202107-1140-001
Received in OIRA
DOJ/ATF
Financial History Questionnaire
New collection (Request for a new OMB Control Number)   No
Regular 07/21/2021
  Requested Previously Approved
36 Months From Approved
2,000 0
333 0
2,000 0

The Financial History Questionnaire ̶ ATF Form 8620.28 will be used to determine if a candidate for Federal or contractor employment at the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), satisfies all just financial obligations.

None
None

Not associated with rulemaking

  86 FR 22705 04/29/2021
86 FR 38359 07/20/2021
No

1
IC Title Form No. Form Name
Financial History Questionnaire ATF Form 8620.28 Financial History 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 2,000 0 0 2,000 0 0
Annual Time Burden (Hours) 333 0 0 333 0 0
Annual Cost Burden (Dollars) 2,000 0 0 2,000 0 0
Yes
Miscellaneous Actions
No
This is a new information collection which has an impact on the public. An estimated 2,000 respondents will use the form annually, and it will take each respondent approximately 10 minutes to complete their responses. Therefore, the total public burden associated with this collection is 333 hours. The total public cost burden is $ 2,000.

$0
No
    Yes
    Yes
No
No
No
No
Lakisha Gregory 202 648-9260

  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.
07/21/2021


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