E-Appeal/US Merit Systems Protection Board Appeal Form

ICR 202201-3124-002

OMB: 3124-0009

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2017-07-26
Supporting Statement A
2013-04-03
IC Document Collections
IC ID
Document
Title
Status
ICR Details
3124-0009 202201-3124-002
Received in OIRA 201905-3124-002
MSPB
E-Appeal/US Merit Systems Protection Board Appeal Form
Reinstatement without change of a previously approved collection   No
Regular 01/07/2022
  Requested Previously Approved
36 Months From Approved
7,150 0
7,150 0
0 0

This is a voluntary form completed by persons who file appeals with the U.S. Merit Systems Protection Board. The form serves as a guide to appellants in providing all needed information. It is available both as a static form, which is available upon request, on our website (http://www.mspb.gov/appeals/revisedappealform.htm).

US Code: 5 USC 1204, 1221, 3330a, 7701 Name of Law: Civil Service Reform Act and others
  
None

Not associated with rulemaking

  77 FR 71640 12/03/2012
78 FR 20142 04/03/2013
No

0

  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 7,150 0 0 0 0 7,150
Annual Time Burden (Hours) 7,150 0 0 0 0 7,150
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
No
Fon Muttamara 202 254-4772 [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.
01/07/2022


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