Grant Recipient's Accounting System and Financial Capability Questionnaire

Forms and Documents

Document Name	Status
Form NA Form 17003 Grant Recipient's Accounting System and Financial Capability Questionnaire Form and Instruction	Modified
2021SSQuestionnarie-NHPRC_0072_FINAL.pdf Supporting Statement A	2021-08-27

IC Document Collections

IC ID	Document Title	Status
202670	Grant Recipient's Accounting System and Financial Capability Questionnaire Form and Instruction	Modified

ICR Details

OMB Control No: 3095-0072	ICR Reference No: 202108-3095-009
Status: Received in OIRA	Previous ICR Reference No: 201807-3095-004
Agency/Subagency: NARA	Agency Tracking No:
Title: Grant Recipient's Accounting System and Financial Capability Questionnaire
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular	Date Submitted to OIRA: 08/27/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2021
Responses	75	75
Time Burden (Hours)	300	300
Cost Burden (Dollars)	0	0

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Abstract: Some of the recipients of grants from the National Historical Publications and Records Commission (NHPRC) have proven to have limited experience with managing Federal funds. This questionnaire is designed to identify those potential recipients and provide appropriate training or additional safeguards for Federal funds. Additionally, the questionnaire serves as a pre-audit function in identifying potential deficiencies and minimizing the risk of fraud, waste, abuse, or mismanagement, which we use in lieu of a more costly and time consuming formal pre-award audit.

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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:
	86 FR 24670	05/07/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 41522	08/02/2021
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
Grant Recipient's Accounting System and Financial Capability Questionnaire	NA Form 17003	Grant Recipient's Accounting System and Financial Capability Questionnaire

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ICR Summary of Burden

	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	75	75	0	0	0	0
Annual Time Burden (Hours)	300	300	0	0	0	0
Annual Cost Burden (Dollars)	0	0	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: $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.     No

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? No

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Common Form ICR:  Yes

Description/Changes for Common Form Usage:  On page 1 of NA Form 17003, Grant Recipient's Accounting System and Financial Capability Questionnaire, under Federal Audit Data, this line: OMB A-133 Single Audit (required of institutions that received more than $750,000 in 2014 in Federal grants; or $500,000 in years prior to 2014) was revised to this line: Single Audit in accordance with 2 CFR 2600 and 2 CFR 200 Subpart F (required of institutions that spent more than $750,000 in Federal awards)

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 08/27/2021

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