PRA Final Supporting Statement A - MSPB Appeal Form 185 3-29-2013

PRA Final Supporting Statement A - MSPB Appeal Form 185 3-29-2013.pdf

E-Appeal/US Merit Systems Protection Board Appeal Form

OMB: 3124-0009

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SUPPORTING STATEMENT A
JUSTIFICATION:
1. Circumstances that make the collection of information necessary.
The Merit Systems Protection Board (MSPB or Board) is authorized to adjudicate
appeals of certain Federal agency personnel and retirement actions and certain alleged
violations of law. See 5 U.S.C. §§ 1204, 1221, 3330a and 7701, and 38 U.S.C. § 4324.
The Board has published its regulations for processing appeals at 5 C.F.R. Parts 1201,
1208, and 1209. The Board’s regulations require that appellants provide certain
information when filing an appeal so that the Board can determine whether it has
jurisdiction over the appeal and whether it has been filed within the applicable time limit.
Although an appeal may be filed in any format, including letter form, MSPB provides an
appeal form (MSPB Form 185) so that a person seeking to file an appeal will know that
he or she is providing all information required for the Board to initiate processing. In
addition, MSPB implemented an electronic filing system, e-Appeal Online (https://eappeal.mspb.gov), as an alternative means to collect the same information as MSPB
Form 185. Other than the difference in medium, e-Appeal Online differs from the static
form in that the question-and-answer process is interactive, i.e., the responses to
questions determine subsequent questions. This eliminates the need for an appellant to
answer “not applicable” to or otherwise skip some portions of the form.
In compliance with the Paperwork Reduction Act of 1995 (PRA), MSPB forwards to the
Office of Management and Budget (OMB) for review and approval an information
collection request (ICR) package for the revised MSPB Form 185. (Corresponding
modifications have been made to e-Appeal Online.) The MSPB is requesting public
comments on the MSPB Form 185, which is available for review on MSPB’s website at
http://www.mspb.gov/appeals/revisedappealform.htm

2. Purpose the information is to be used for.
Using MSPB Form 185 or MSPB’s e-Appeal Online system ensures that all required
information is provided when individuals file appeals with MSPB.

3. Uses of the information and consequences of not collecting it.
Both MSPB Form 185 and e-Appeal Online request basic information from persons who
initiate proceedings before the Board including: name and address; the name and address
of the appellant’s designated representative (if any); the name and address of the agency
that took the appealed action, the nature of the action, and an explanation of why the
appellant believes the action was wrong, including whether the appellant believes the
agency engaged in harmful procedural error, committed a prohibited personnel practice,
or engaged in discrimination. The specific requirements are set forth in MSPB’s
regulations at 5 C.F.R. §§ 1201.24, 1208.13, 1208.23, and 1209.6. Although use of either
MSPB Form 185 or e-Appeal Online is voluntary, each helps to ensure that an appellant
will provide the basic information necessary for MSPB to determine whether the action
falls within its appellate jurisdiction, and enables MSPB to docket the appeal and obtain
the file on the appealed action from the appropriate agency.

4. Efforts to identify duplication.
No duplication will exist since the responses are personal and based on specific
circumstances applicable to an individual appellant.

5. Why similar information already available cannot be used.
No similar information is already available since the responses are personal and based on
specific circumstances applicable to an individual appellant.

6. Methods used to minimize burden on small businesses or other small entities
This information collection is not applicable to small businesses or other small entities.

7. Consequences if information was collected less frequently.
Respondents provide the information only one time per appeal.

8. Special circumstances requiring collection inconsistent with guidelines in 5 C.F.R.
1320.6.

None.

9. Efforts to consult with persons outside the agency on the availability of the
information.
Not applicable.

10. Describe assurances of confidentiality given to respondents.
The Privacy Act Statement on both MSPB Form 185 and e-Appeal Online state that the
decisions of the Board are final administrative decisions and, as such, are available to the
public under the provisions of the Freedom of Information Act (FOIA). The Privacy Act
Statement also forms respondents that decisions of the Board are posted to the Board’s
public website (www.mspb.gov). Additionally, it is possible that information contained
in the appeal file may be released as required by FOIA. Certain information about
appeals will also be used in depersonalized form in a database for program statistics.

11. Justification for any questions of a sensitive nature.
The Privacy Act Statement on both MSPB Form 185 and e-Appeal Online state that the
personal information requested is relevant and necessary to reach a decision in an appeal.
The MSPB collects the information in order to process an appeal under its statutory and
regulatory authority. Since an appeal is a voluntary action, the appellant is not required
to give any personal information. However, failure to supply the Board with all the
essential information could result in the rejection or dismissal of an appeal.

12. Provide estimates of the burden of the collection of information on respondents.
The public burden for this collection of information is estimated to vary from 20 minutes
to 4 hours, with an average of 60 minutes per response, including time for reviewing the
form and instructions, searching existing data sources, gathering the data necessary, and
completing and reviewing the collection of information.

13. Total annual cost burden.

Costs associated with this information collection are expected to be nominal. Any cost
incurred by an appellant’s reproduction of a personal copy of the form submitted to
MSPB, and by the use of stationery, postage, a fax machine, or Internet are considered to
be normal costs incurred as part of customary business or private practices.

14. Provide estimates of annualized costs to the Federal government.
Both MSPB Form 185 and e-Appeal Online have been in use for a substantial period of
time. The only costs to the Federal government entailed in the proposed revision to the
appeal form are staff time devoted to researching and editing the static form and the
corresponding modifications to e-Appeal Online. The MSPB does not incur printing
costs for MSPB Form 185, instead making it available for download from our public
website and mailing paper copies only when requested.

15. Program Changes or Adjustments.
Not applicable.

16. Outline plans for use and publication.
Both MSPB Form 185 and e-Appeal Online will only be used by MSPB to elicit pertinent
information from appellants. Their only use is to provide information to the Board
necessary to adjudicate an appeal.

17. Reason for not displaying expiration date.
Not applicable.

18. Exceptions to Certification.
Not applicable.


File Typeapplication/pdf
File TitleBlank Document
AuthorUS MSPB
File Modified2013-03-29
File Created2013-03-29

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