83-1

PAPERWORK REDUCTION ACT SUBMISSION

Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your agency's Paperwork
Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation
to: Office of Information and Regulatory Affairs, Office of Management and Budget, Docket Library, Room 10102, 725 17th Street NW,
Washington, DC 20503.

1. Agency/Subagency originating request
FBI/CJIS

1110

3. Type ofinformation collection (check one)

a. [J New Collection

b. |7] Revision of acurrently approved collection
c. [_] Extension of acurrently approved collection
d. Q Reinstatement, without change, of a previously approved
collection forwhich approval has expired

e. 0 Reinstatement, with change, of a previously approved

b. 0 None

2. OMB control number

0068

4. Type ofreview requested (check one)

a. 0 Regular
b. LJ Emergency - Approval requested by:

For b-f, note item A2of Supporting Statement instructions

/

5. Small entities

Will this information collection have a significant economic impact ona
substantial number of small entities?

Yes D

collection forwhich approval has expired

f. 0 Existing collection in use without an OMB control number

_/

c. I IDelegated

No

\7\

6. Requested expiration date

a. Ej Three years from the approval date

7. Title

Records Modification Form
8. Agency form number(s) (ifapplicable)
FD-1115

9. Keywords

Modify, arrest, court, charge, disposition
10. Abstract

DOJ's CJIS is requesting a PRA approval for an revision of a currently approved collection.
11. Affected public (Mark primary with "P" and all others with "X")

12. Obligation torespond (Mark primary with "P" and all others that apply with "X")

a. _ Individuals or households

d. _ Farms

a. PI Voluntary

b. _ Business orother for-profit
c.__ Not-for-profit institutions

e.X_ Federal Government
f. X State, Local, orTribal Government

c. I IMandatory

13. Annual reporting and recordkeeping hour burden

a. Number ofrespondents

43,584

b.Total annual responses

119,293

. Percentageofthese responses
collected electronically

0

b. \_j Required toobtain orretain benefits

14. Annual reporting and recordkeeping cost burden (in thousands ofdollars)
a. Total annualized capital/startup costs
b. Total annual costs (O&M)
c. Total annualized cost requested

N/A

d. Current OMB inventory

0

125,907

c. Total annual hoursrequested

19,882

e. Difference

d. Current OMB inventory

0

f. Explanation of difference

e. Difference

2,129

f. Explanation of difference

1. Program change

N/A

2. Adjustment

Yes

15. Purpose ofinformation collection (Mark primary with "P" and all others
that apply with "X")

N/A

572,108

1. Programchange

N/A

2. Adjustment

Yes

16. Frequency ofrecordkeeping orreporting (check all that apply)

a. 0 Recordkeeping

a. _ Application for benefits

e. _ Program planning ormanagement :. 0 Reporting:

b. _ Programevaluation

f. _ Research

b. •

Third party disclosure

1.

On occasion

2. • Weekly

c. _ General purpose statistics g. P_ Regulatory or compliance

4.

Quarterly

5.

Semi-annually 6. • Annually

d.

7.

Biennially

8.

Other (describe)

Audit

3. [jfonthly

18. Agency contact (person who can best answer questions regarding the content

17. Statistical methods

Does this information collection employ statistical methods?

Yes I INo [7]

of this submission)
Name: GerrY Lynn Brovey, SupervisoryInformation Liaison Specialist

Phone: (304) 625-4320
OMB 83-I

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19. Certification for Paperwork Reduction Act Submissions

On behalf of this Federal agency, Icertify that the collection of information encompassed by this request complies with
5 CFR 1320.9.

NOTE: The text of 5CFR 1320.9, and the related provisions of 5CFR 1320.8(b)(3), appear at the end of the
instructions. The certification is to be made with reference to those regulatory provisions as set forth in
the instructions.

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for theproper performance ofagency functions;
(b) If avoids unnecessary duplication;
(c) Itreduces 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 5CFR 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 ofconfidentiality; and
(vi) Need todisplay currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective manage
ment and use of the information to be collected (see note in Item 19 of the instructions);
(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 below and explain the reason in
Item 18 ofthe Supporting Statement.

Signature ofSenior Official ordesignee

Date

(/J^uU d-fyUto+y/yHtfOMB 83-1

10/95

Instructions For Completing OMB Form 83-1
5. Small entities

Please answerallquestions and have the SeniorOfficial or
designee sign the form. These instructions should be used

inconjunction with 5 CFR 1320, which provides information
oncoverage, definitions, andother matters ofprocedure and
interpretation underthe Paperwork Reduction Actof 1995.

1. Agency/Subagencyoriginating request

Indicate whether this information collection will have a
significant impacton a substantial numberof small entities.

Asmall entity may be (1) a small business which is deemed
to be onethatis independently owned andoperated and
that is not dominant in itsfield ofoperation; (2) a small
organization thatis anynot-for-profit enterprise thatis
independently owned and operatedand is notdominant in

Provide thename oftheagency orsubagency
originating the request. For most cabinet-level

agencies, a subagency designation is alsonecessary.
Fornon-cabinet agencies, the subagency designation is

itsfield; or (3) a small government jurisdiction which is a
government of a city, county, town, township, school
district, orspecial district with a population of less than
50,000.

generally unnecessary.

13.Annualreporting and recordkeeping hour burden

a. Enter thenumber ofrespondents and/or recordkeepers.
If a respondent isalsoa recordkeeper, report the
respondent only once.

b. Enter the number ofresponses provided annually. For
recordkeeping as compared to reporting activity, the
number ofresponses equals the number ofrecordkeepers.
b1. Enter the estimated percentage ofresponses thatwill
be submitted/collected electronically using magnetic media
(i.e., diskette), electronic mail, or electronic data
interchange. Facsimile is not considered an electronic
submission.

6. Requested expiration date
2. OMB control number

c. Enter thetotal annual recordkeeping and reporting hour

a. Check "Three years" ifthe agency requests a three year

burden.

a. If the information collection inthis request has

approval for the collection.

previouslyreceived or now has an OMB control or
comment number, enter the number.

b. Check "Other" ifthe agency requests approval forless
thanthree years. Specify the month andyearofthe

d. Enter the burden hours currently approved byOMB for
this collection ofinformation. Enter zero(0) for anynew
submission orfor anycollection whose OMB approval has

b. Check "None" if the information collection in this

requested expirationdate.

request has not previously receivedan OMB control

number. Enter thefour digit agency codefor your

7. Title

agency.

parentheses.

Provide the official titleof the information collection. Ifan

3.Type of information collection (check one)

official title does not exist, provide a description which will
distinguishthis collectionfromothers.

a. Check "New collection" when the collection has not

previously been usedorsponsored bythe agency.

c. Check "Extension" when thecollection iscurrently
approved byOMB, and the agency wishes only to
extendthe approval past the current expiration date
without making any material change inthe collection
instrument, instructions, frequency ofcollection, or the
use to which the information is to be put.

d. Check "Reinstatement without change" when the
collection previously hadOMB approval, butthe
approval has expiredor was withdrawn beforethis

submission was made, and there is nochange to the
collection.

f. Explain the difference. The difference in line e must be
accounted for in lines f.1. and f.2.

8. Agency form number(s) (ifapplicable)

f.1. "Program change" is the resultof deliberate Federal
government action. All newcollections and any
subsequent revision ofexisting collections (e.g., the

Provide any form number theagency hasassigned tothis

addition ordeletion ofquestions) are recorded as program

b. Check "Revision" when the collection iscurrently
approved by OMB, and the agency request includesa
material change to the collection instrument,
instructions, its frequency of collection, or the use to
which the information is to be put.

expired.

e. Enter the difference bysubtracting line d from line c.
Record a negative number (d larger than c) within

collection of information. Separate each form number with a

changes.

comma.

f.2. "Adjustment" is a change that is notthe resultof a

9. Keywords

Select and list at least two keywords (descriptors) from the
"Federal Register Thesaurus ofIndexing Terms" that
describethe subjectarea(s) of the information collection.
Otherterms maybe used butshouldbe listed afterthose

selected from thethesaurus. Separate keywords with
commas. Keywords should not exceed two lines of text.

deliberate Federal government action. Changes resulting
from new estimates oraction not controllable by the
Federal government are recorded as adjustments.

14.Annual reporting and recordkeeping cost burden
(inthousands of dollars)
The costs identified in this item must exclude the cost of
hour burden identified in Item 13.

10. Abstract

a. Enter the total dollar amount of annualized cost for all

Provide a statement, limited tofive lines oftext, covering

b. Enterrecurring annualdollar amount of cost forall

respondents ofany associated capital orstart-up costs.

e. Check "Reinstatement with change" when the

the agency's need for the information, uses to which it will

collection previously had OMB approval, butthe
approval has expiredor was withdrawn before this

be put, and a brief description ofthe respondents.

systems or purchasingservices.

submission was made, andthere is change to the

11. Affected public

c. Enter total (14.a. +14.b.) annual reporting and
recordkeeping cost burden.

collection.

f. Check "Existing collection in use without OMB control

Mark all categories that apply, denoting the primary public

number" when the collection is currently in use butdoes

with a "P" andall others thatapply with "X."

not have a currently valid OMB control number.

4.Typeof review requested (check one)

Mark all categories that apply, denoting the primary

b. Check "Emergency" when the agency issubmitting
the request under 5 CFR 1320.13 for emergency
processing and provides the required supporting
material. Provide the date bywhich the agency
requests approval.

c. Check "Delegated" when the agency issubmitting
thecollection under theconditions OMB hasgranted
the agencydelegated authority.

d. Enter anycost burden currently approved byOMB for
this collection ofinformation. Enter zero (0) ifthis is the
first submission after October1,1995.

12. Obligation to respond

a. Check "Regular" whenthe collection is submitted
under 5 CFR 1320.10,1320.11,or 1320.12witha
standard 60 day review schedule.

respondents associated with operating or maintaining

obligation with a "P" and all others thatapply with "X."

a. Mark "Voluntary" when theresponse isentirely
discretionary and has nodirect effect onany benefit or
privilege forthe respondent.
b. Mark "Required to obtain or retain benefits" when the
response is elective, but is required to obtain or retaina
benefit.

e. Enter the difference bysubtracting line d from line c.
Record a negative number (dlarger than c)within
parenthesis.

f. Explain the difference. The difference in line e must be
accounted for in lines f.1. and f.2.

f.1. "Program change" is the result ofdeliberate Federal
government action. All newcollections and any
subsequent revisions orchanges resulting incostchanges
are recordedas program changes.

c. Mark "Mandatory" when therespondent must reply or
face civil or criminal sanctions.
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f.2. "Adjustment" is a change that is notthe resultof a
deliberate Federal government action. Changes
resultingfrom new estimations or actions not
controllable by the Federal government are recorded
as adjustments.
15. Purpose of information collection

Mark allcategories that apply, denoting the primary
purposewith a "P"and all others that applywith "X."
a. Mark "Application for benefits" when the purpose is
to participate in, receive,or qualify for a grant,financial
assistance, etc., from a Federal agency or program.
b. Mark "Program evaluation" whenthe purpose is a
formal assessment, through objective measures and
systematic analysis, of the manner and extent to which
Federal programs achieve theirobjectivesor produce
other significant effects.
c. Mark "General purpose statistics" when the data is
collectedchiefly for use by the public or for general
government use without primary reference to the policy
or program operations of the agency collecting the
data.

d. Mark "Audit" whenthe purpose is to verify the
accuracy of accounts and records.
e. Mark "Program planningor management" when the
purpose relates to progress reporting, financial
reportingand grants management, procurement and
qualitycontrol,or other administrativeinformation that
does not fit intoany other category.

f. Mark "Research" when the purposeis to further the
course of research, ratherthan fora specific program
purpose.

18. Agency contact
Providethe name and telephone numberof the agency
person best able to answer questions regarding the
content of this submission.

g. Mark"Regulatoryor compliance" when the
purpose is to measure compliance with laws or
regulations.

16. Frequency of recordkeeping or reporting
Check "Recordkeeping" ifthe collectionof information
explicitly includes a recordkeeping requirement.
Check "Thirdparty disclosure" if a collection of
information includes third-party disclosure

requirements as defined by 1320.3(c).

19. Certification for Paperwork Reduction Act
Submissions

The SeniorOfficial or designee signing this statement
certifiesthat the collection of information encompassed
by the request complies with5 CFR 1320.9. Provisions
of this certification that the agencycannotcomply with
should be identified here and fully explained in item 18 of
the attached SupportingStatement. NOTE: The Office
that "develops" and "uses" the information to be collected

is the officethat "conducts or sponsors" the collection of
information. (See 5 CFR 1320.3(d)).

Check "Reporting" for information collections that
involve reporting and check the frequency of reporting
that is requested or required of a respondent. Ifthe
reportingis on "an event" basis, check "On occasion."
17. Statistical methods

Check "Yes" if the information collection uses

statistical methods such as samplingor imputation.
Generally, check "No" for applications and audits
(unless a random auditing scheme is used). Check
"Yes" for statistical collections, most research

collections, and program evaluationsusingscientific
methods. For other types of data collection, the use
of sampling, imputation, or other statistical estimation
techniques should dictate the response for this item.

Ensurethat supporting documentation is provided in
accordance with Section B of the Supporting
Statement.

10/95

Certification Requirement for Paperwork Reduction ActSubmissions

5CFR 1320.9 reads "As part of the agency submission to OMB of aproposed collection of information, the agency (through
the head of the agency, the Senior Official, or their designee) shall certify (and provide arecord supporting such certification)
that the proposedcollection of information-

"(a) is necessary for the proper performance of the functions of the agency, including that the information to be collected
will have practical utility;

"(b) is not unnecessarily duplicative of information otherwise reasonably accessible to the agency;
"(c) reduces to the extent practicable and appropriate the burden on persons who shall provide information to or for the
agency, including with respect to small entities, as defined in the Regulatory Flexibility Act (5 U.S.C. §601(6)), the use of such
techniques as:

"(1) establishing differing compliance or reporting requirements or timetables that take into account the resources
available tothose who are to respond;

"(2) the clarification, consolidation, or simplification of compliance and reporting requirements; or collections of infor
mation, or any part thereof;

"(3) an exemption from coverage of the collection of information, or any part thereof;

"(d) is written using plain, coherent, and unambiguous terminology and is understandable to those who are to respond;

"(e) is to be implemented in ways consistent and compatible, to the maximum extent practicable, with the existing reporting
and recordkeeping practices of those who are to respond;

"(f) indicates for each recordkeeping requirement the length of time persons are required to maintain the records specified;
"(g) informs potential respondents of the information called for under §1320.8(b)(3); [see below]

"(h) has been developed by an office that has planned and allocated resources for the efficient and effective management and
use of the information to be collected, including the processing of the information in a manner which shall enhance, where
appropriate, the utility of the information toagencies and the public;

"(i) uses effective and efficient statistical survey methodology appropriate to the purpose for which the information is to be
collected; and

"(j) to the maximum extent practicable, uses appropriate information technology to reduce burden and improve data quality,
agency efficiency and responsiveness tothe public."
NOTE: 5 CFR 1320.8(b)(3) requires thateach collection of information:

"(3) informs and provides reasonable notice to the potential persons to whom the collection of information is addressed of:
"(i) the reasons the information is planned to be and/or has been collected;

"(ii) the way such information is planned to be and/or has been used to further the proper performance of the functions
of the agency;

"(iii) an estimate, to the extent practicable, of the average burden of the collection (together with arequest that the
public direct to the agency any comments concerning the accuracy of this burden estimate and any suggestions for reducing
this burden);

"(iv) whether responses to the collection of information are voluntary, require to obtain or retain a benefit (citing
authority) ormandatory (citing authority);

"(v) the nature and extent of confidentiality to be provided, if any (citing authority); and

"(vi) the fact that an agency may not conduct or sponsor, and a person is not required to respond to, acollection of
information unless it displays a currently valid OMB control number."

10/95

Supporting Statement for Paperwork Reduction Act Submissions
General Instructions
ASupporting Statement, including thetextofthe notice to
thepublic required by 5 CFR 1320.5(a)(i)(iv) and its actual
orestimated dateofpublication in the Federal Register,

*requiring respondents to retain records, otherthan

is requested, and anysteps to be takento obtain

health, medical, government contract, grant-in-aid, or

their consent.

must accompany each requestforapproval of a collection of

tax records, for more thanthreeyears;
*inconnection with a statistical survey, thatis not

information. The Supporting Statement must be prepared in

designed to produce valid and reliable results that can

12. Provide estimates of the hour burden of the
collection of information. The statement should:

the format described below,and must contain the
information specifiedin Section A below. Ifan itemis not

begeneralized tothe universe ofstudy;

*Indicate the number ofrespondents, frequency of

*requiring the use of a statistical data classification that

response, annual hour burden, and an explanation of

applicable, provide a brief explanation. When Item 17of the
OMB Form 83-I is checked"Yes", Section B of the

has not been reviewed and approved by OMB;
*thatincludes a pledge ofconfidentiality thatis not

doso,agencies should not conduct special surveys

how the burden was estimated. Unless directed to

Supporting Statement must be completed. OMB reserves

supported by authority established in statute or

to obtain information on which to base hour burden

the right to require the submissionof additional information
with respectto any requestforapproval.

regulation, that is notsupported bydisclosure and data
security policies thatare consistent with the pledge, or
which unnecessarily impedes sharing of data with other

estimates. Consultation with a sample (fewer than

Specific Instructions

agencies for compatible confidential use; or

A. Justification

secrets, or other confidential information unless the

*requiring respondents tosubmit proprietary trade
agency can demonstrate that it has instituted

10) of potential respondents is desirable. Ifthe hour

burden on respondents is expected to vary widely
becauseofdifferences in activity, size, or
complexity, showthe range ofestimated hour
burden, and explainthe reasons for the variance.
Generally, estimates should not include burden

1. Explain the circumstances that make the collection of

procedures to protect theinformation's confidentiality to

hours for customary and usual business practices.

information necessary. Identify any legal or administrative

the extent permitted by law.

* Ifthis requestforapproval covers more than one
form, provide separate hour burdenestimates for
each form and aggregate the hourburdens in Item

requirements that necessitate thecollection. Attach a copy
oftheappropriate section ofeach statute and regulation
mandating or authorizing the collection of information.

2. Indicate how, bywhom, andfor what purpose the
information is to be used. Except fora newcollection,

8. If applicable, provide a copy and identify thedate
and page number ofpublication in the Federal Register
ofthe agency's notice, required by 5 CFR 1320.8(d),
soliciting comments on the information collection prior
to submission to OMB. Summarize public comments

indicate the actual use the agencyhas madeofthe

received in response to that notice and describe actions

information received from the current collection.

takenbythe agency in response to these comments.

3. Describe whether, and to whatextent, the collection of
information involves the use of automated, electronic,

mechanical, orother technological collection techniques or

other forms ofinformation technology, e.g., permitting

13ofOMBForm83-l.

* Provide estimates of annualized cost to

respondents for the hour burdens for collections of

information, identifying and using appropriate wage
ratecategories. Thecostofcontracting outor paying

Specifically address comments receivedon cost and

outside parties for information collection activities
should not be included here. Instead, this cost

hour burden.

should be included in Item 13.

Describe efforts to consult with persons outside the
agency to obtain their views on the availability ofdata,
frequency of collection, the clarity of instructions and

13. Provide an estimate for the total annual cost

electronic submission of responses, and the basisforthe

recordkeeping, disclosure, orreporting format (if any),

burden to respondents or recordkeepers resulting
from the collection of information. (Do notinclude

decisionfor adopting this means of collection. Alsodescribe

and on the data elements to be recorded, disclosed, or

the cost of any hour burdenshown in Items 12 and

anyconsideration of using information technology to reduce

reported.

14).

burden.

Consultation with representatives of those from whom
information is to be obtained or those who must

*Thecost estimate should be splitinto two
components: (a) a total capital and start-upcost

4. Describe efforts toidentify duplication. Show specifically

compile records should occur at least once every 3
years - even ifthecollection ofinformation activity is
thesame as in prior periods. There may be

and (b) a total operationand maintenance and
purchaseofservices component. The estimates

why anysimilar information already available cannot be
usedor modified for use for the purposes described in Item
2 above.

component (annualized overitsexpected useful life)

circumstances that maypreclude consultation ina

should take into account costs associated with

specific situation. These circumstances should be
explained.

generating, maintaining, anddisclosing or providing
the information. Include descriptions of methods

any methods used to minimize burden.

9. Explain any decision toprovide any payment orgift

and technology acquisition, expected useful life of

6.Describe the consequence toFederal program orpolicy

to respondents, other than reenumeration of
contractors or grantees.

capital equipment, the discount rate(s), andthetime
period over which costs will be incurred. Capital and

10. Describe any assurance ofconfidentiality provided

start-up costs include, amongother items,
preparations forcollecting information such as

5. If the collection ofinformation impacts small businesses
orother small entities (Item 5 ofOMB Form 83-1), describe

used toestimate major costfactors including system

activities ifthe collection is not conducted or is conducted

lessfrequently, as well as any technical orlegal obstacles
to reducing burden.

to respondents and the basis for the assurance in

purchasing computers and software; monitoring,

statute, regulation, or agency policy.

sampling, drilling and testingequipment; and record

*If costestimates areexpected to vary widely,

moreoftenthan quarterly;

11. Provide additional justification for any questions ofa
sensitive nature, suchas sexual behavior andattitudes,
religious beliefs, and other matters that arecommonly

*requiring respondents to prepare a written response toa
collection ofinformation in fewer than 30days after receipt

considered private. This justification should include the
reasonswhy the agency considers the questions

7. Explain any special circumstances that would cause an
informationcollection to be conducted in a manner:

*requiring respondents toreport information tothe agency

storage facilities.

of it;

necessary, the specific uses to be made of the

*requiring respondents tosubmit more than anoriginal and

information, theexplanation to begiven to persons from

two copies of any document;

whom the information

agenciesshould present ranges of cost burdensand
explain the reasons for the variance. The cost of

purchasing or contracting out information collections
services should be a part of this cost burden
estimate. In developing cost burden estimates,

agencies may consult with a sample of respondents
(fewer than10), utilize the 60-day pre-OMB
submission public comment process and use

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existing economic orregulatory impact analysis
associated with the rulemaking containing the
information collection, as appropriate.
*Generally, estimates should not include

purchases ofequipment or services, or portions

thereof, made: (1) prior toOctober 1,1995, (2) to
achieve regulatory compliance with requirements
not associated with the information collection, (3)
forreasonsotherthanto provide information or
keep records for thegovernment, or(4) as part of
customaryand usual business or private
practices.
14. Provide estimates of annualized costs to the

Federal government. Also, provide a description of
the method used to estimate cost, whichshould

include quantification of hours, operational

expenses (such as equipment, overhead, printing,
and support staff), and anyotherexpensethat
would not have been incurred without this

collection of information. Agencies may also

17. If seeking approval to not display theexpiration
datefor OMB approval ofthe information collection,
explain the reasons thatdisplay would be
inappropriate.

*Statistical methodology for stratification and sample
selection,

* Estimation procedure,

18. Explain each exception to the certification

*Degree ofaccuracy needed for the purpose described in

statement identified in Item 19, "Certificationfor

the justification,

Paperwork Reduction ActSubmissions," of OMB Form

*Unusual problems requiring specialized sampling

83-I.

procedures, and

*Any useofperiodic (less frequent than annual) data
B.Collections of Information Employing

collection cycles to reduce burden.

Statistical Methods

The agency should beprepared tojustify itsdecision not to
use statistical methods inany case wheresuch methods
might reduce burden or improve accuracy of results. When
Item 17 on the Form OMB 83-I is checked, "Yes," the
following documentation should be included in the

Supporting Statement to the extend that itapplies tothe

3. Describe methods to maximize response ratesandto
deal with issues ofnon-response. The accuracy and
reliability of information collectedmust be shown to be
adequate for intended uses. For collections based on

sampling, a special justification must be provided for any
collection that will not yield "reliable" data that can be
generalized to the universe studied.

methods proposed:

4. Describe any tests of procedures or methods to be
undertaken. Testing is encouraged as an effective means

aggregate cost estimates from Items 12, 13, and

14 ina singletable.

15.Explain the reasons for anyprogram changes

1. Describe (including a numerical estimate) the
potential respondent universe andanysampling or

or adjustments reportedin Items 13 or 14 of the

other respondent selection methods to be used. Data

OMB Form 83-I.

onthe number ofentities (e.g., establishments, State

and local government units, households, orpersons)
will be published, outline plansfortabulation and
publication. Address anycomplex analytical

inthe universe covered bythe collection and in the
corresponding sample are to be provided intabular
form for the universeas a wholeand for each of the

techniques that will be used. Provide the time

stratain the proposed sample. Indicate expected

16. For collections of informationwhose results

2. Describe the procedures forthe collection of information
including:

schedule for the entire project, including beginning

response rates for the collection as a whole. If the

and ending dates of the collection of information,
completion of report, publication dates, and other

collection had been conducted previously, include the
actual response rateachieved during the last

actions.

collection.

of refining collections of information to minimize burden and

improve utility. Tests must be approved ifthey call for
answers to identicalquestions from 10 or more

respondents. Aproposed testorset oftest may be
submitted forapproval separately or incombination with the
main collection of information.

5. Provide the nameand telephone number of individuals
consulted on statistical aspectsofthe design andthe name
ofthe agency unit, contractor(s), grantee(s), orother
person(s) who will actually collect and/or analyze the
information forthe agency.

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