Application for Domestic Indemnification

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3135-0123 Application for Domestic Indemnification	Form and Instruction	Modified	Available
Form 3135-0123 Application for Domestic Indemnification	Form and Instruction	Modified	Repair queued
Domestic Indemnity Supporting Statement A.pdf	Supporting Statement A	Uploaded 2023-01-25	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
246725	Application for Domestic Indemnification	Form and Instruction	Modified	Application for Domestic Indemnification
246725	Application for Domestic Indemnification	Form and Instruction	Modified

ICR Details

OMB Control No: 3135-0123	ICR Reference No: 202301-3135-002
Status: Historical Active	Previous ICR Reference No: 202003-3135-010
Agency/Subagency: NEA	Agency Tracking No: 3135NEA-Indemnity
Title: Application for Domestic Indemnification
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/15/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/25/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2026	36 Months From Approved	04/30/2024
Responses	18	0	18
Time Burden (Hours)	720	0	720
Cost Burden (Dollars)	37,746	0	37,746

---

Abstract: Applicants for federal domestic indemnity under the Arts and Artifacts Indemnity Act (P.L. 94-158) are required to submit indemnity applications. Respondents include non-profit, tax-exempt organizations (primarily museums).

---

Authorizing Statute(s): PL: Pub.L. 94 - 158 1, 89 Stat. 844 Name of Law: Arts and Artifacts Indemnity Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 67077	11/07/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 4855	01/25/2023
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Application for Domestic Indemnification	3135-0123	Application for Domestic Indemnification

---

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	18	18	0	0	0	0
Annual Time Burden (Hours)	720	720	0	0	0	0
Annual Cost Burden (Dollars)	37,746	37,746	0	0	0	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:

---

Annual Cost to Federal Government: $288,154

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.     No

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.     No

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

---

Common Form ICR:  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:

(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: 01/25/2023

---