Repayment of a buyout prior to re-employment with the Federal Government

Forms and Documents

Document Name	Status
Form 12311 Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay Form	Unchanged
Supporting Statement.docx Supporting Statement A	2021-10-27

IC Document Collections

IC ID	Document Title	Status
19621	Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay Form	Unchanged

ICR Details

OMB Control No: 1545-1920	ICR Reference No: 202110-1545-016
Status: Received in OIRA	Previous ICR Reference No: 201808-1545-006
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Repayment of a buyout prior to re-employment with the Federal Government
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 02/28/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved	02/28/2022
Responses	6,624	6,624
Time Burden (Hours)	530	530
Cost Burden (Dollars)	0	0

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Abstract: Form 12311 outlines the regulations requiring those employees being rehired by the government and received a buyout from their previous job to make repayment of the buyout before they will be hired again.

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Authorizing Statute(s): PL: Pub.L. 104 - 208 224 Name of Law: Omnibus Consolidated Appropriations of 1997
   PL: Pub.L. 103 - 226 3 Name of Law: Federal Workforce Restructuring Act of 1994
   PL: Pub.L. 107 - 296 3524 Name of Law: Homeland Security Act of 2002
  

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 47741	08/26/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 10896	02/25/2022
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
Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay	12311	Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay

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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	6,624	6,624	0	0	0	0
Annual Time Burden (Hours)	530	530	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: $2,950

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:  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: 02/28/2022

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