Drug Activity Questionnaire

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 8620.12 Drug Activity Questionnaire	Form and Instruction	New	Repair queued
Form 8620.12 Drug Activity Questionnaire – ATF Form 8620.12	Form and Instruction	New	Repair queued
Executive Order 12564.pdf	Supplementary Document	Uploaded 2022-12-15	Repair queued
Executive Order 13467.pdf	Supplementary Document	Uploaded 2022-12-15	Repair queued
Executive Order 13764.pdf	Supplementary Document	Uploaded 2022-12-15	Repair queued
1140-0NEW Supporting Statement (052023) .docx	Supporting Statement A	Uploaded 2023-05-17	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
257305	Drug Activity Questionnaire – ATF Form 8620.12	Form and Instruction	New	Drug Activity Questionnaire
257305	Drug Activity Questionnaire – ATF Form 8620.12	Form and Instruction	New

ICR Details

OMB Control No: 1140-0130	ICR Reference No: 202212-1140-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: DOJ/ATF	Agency Tracking No:
Title: Drug Activity Questionnaire
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 with change	Conclusion Date: 03/05/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/01/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2027	36 Months From Approved
Responses	2,000	0	0
Time Burden (Hours)	333	0	0
Cost Burden (Dollars)	2,000	0	0

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Abstract: The Drug Activity Questionnaire – ATF Form 8620.12 will be used to collect personally identifiable information (PII), which will be used to determine if a candidate (respondent) can be granted access to ATF information, IT systems, and/or unescorted access to ATF facilities. This collection includes information relating to ATF drug policy requirements.

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Authorizing Statute(s): US Code: 5 USC 736 Name of Law: Intelligence Reform and Terrorism Prevention Act of 2004
   EO: EO 13467 Name/Subject of EO: Reforming Processes Related to Suitability for Government Employment, Fitness for Contractor Employe
   EO: EO 13764 Name/Subject of EO: Amending the Civil Service Rules
  

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:
	88 FR 10936	02/22/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 23467	04/17/2023
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
Drug Activity Questionnaire – ATF Form 8620.12	8620.12	Drug Activity Questionnaire

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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	2,000	0	0	0	2,000	0
Annual Time Burden (Hours)	333	0	0	0	333	0
Annual Cost Burden (Dollars)	2,000	0	0	0	2,000	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: $0

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: 06/01/2023

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