Military Spouse PPP Self-Certification Checklist

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD3145-4 Military Spouse PPP Self-Certification Checklist	Form and Instruction	New	Available
Form DD3145-4 Military Spouse PPP Self-Certification Checklist	Form and Instruction	New	Repair queued
0704-MSSC_SSA_5.24.2023.docx	Supporting Statement A	Uploaded 2023-05-24	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
252932	Military Spouse PPP Self-Certification Checklist	Form and Instruction	New	Military Spouse PPP Self-Certification Checklist
252932	Military Spouse PPP Self-Certification Checklist	Form and Instruction	New

ICR Details

OMB Control No: 0704-0667	ICR Reference No: 202204-0704-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOW/DODDEP	Agency Tracking No: 0704-MSSC
Title: Military Spouse PPP Self-Certification Checklist
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/25/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/24/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2026	36 Months From Approved
Responses	277,448	0	0
Time Burden (Hours)	138,724	0	0
Cost Burden (Dollars)	1,553,709	0	0

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Abstract: In accordance with Section 1784, Title 10, United States Code, Employment Opportunities for Military Spouses, the Military Spouse PPP Self-Certification Checklist must be completed by military spouses when applying for appropriated fund GS-15 and below (or equivalent positions in other pay systems) DoD vacancies in the competitive service or excepted service in order to receive priority consideration for competitive service and excepted service positions at DoD activities in the U.S., and in U.S. territories and possessions.

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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:
	87 FR 25472	04/29/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 32760	05/22/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Military Spouse PPP Self-Certification Checklist	DD3145-4	Military Spouse PPP Self-Certification Checklist

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	277,448	0	0	277,448	0	0
Annual Time Burden (Hours)	138,724	0	0	138,724	0	0
Annual Cost Burden (Dollars)	1,553,709	0	0	1,553,709	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection with a new associated burden.

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Annual Cost to Federal Government: $9,455,427

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.     Yes

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.     Yes

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: 05/24/2023

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