USDA PIV Request for Credential

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form AD-1197 Request for USDA Identification (ID) Badge	Form	Modified	Available
Form AD-1197 USDA PIV Request for Credential	Form	Modified	Repair queued
0505-0022 SuptStmt.docx	Supporting Statement A	Uploaded 2023-05-31	Repair queued
HSPD-12 Directive_001.pdf	Supplementary Document	Uploaded 2020-04-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
985	USDA PIV Request for Credential	Form	Modified	Request for USDA Identification (ID) Badge
985	USDA PIV Request for Credential	Form	Modified

ICR Details

OMB Control No: 0505-0022	ICR Reference No: 202305-0505-001
Status: Historical Active	Previous ICR Reference No: 202004-0505-001
Agency/Subagency: USDA/OCFO	Agency Tracking No:
Title: USDA PIV Request for Credential
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/06/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/31/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2026	36 Months From Approved	07/31/2023
Responses	3,000	0	12,000
Time Burden (Hours)	3,000	0	24,000
Cost Burden (Dollars)	0	0	0

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Abstract: This AD-1197 form is used for information collection pursuant to the approval and issuance of non-PIV credentials, such as a temporary site badge.

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Authorizing Statute(s): PL: Pub.L. 110 - 53 523 Name of Law: The Implementing the 9/11 Recommendtions Act of 2007
  

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 8254	02/08/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 34472	05/30/2023
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
USDA PIV Request for Credential	AD-1197	Request for USDA Identification (ID) Badge

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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	3,000	12,000	0	0	-9,000	0
Annual Time Burden (Hours)	3,000	24,000	0	0	-21,000	0
Annual Cost Burden (Dollars)	0	0	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: There is a decrease in the number of respondents and responses from 12,000 to 3,000 and the burden hours from 24,000 to 3,000. The reason for the decrease is due to the form no longer being used for PIV issuance. This form is now only used for non-PIV issuance, meaning the number of respondents is greatly decreased.

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Annual Cost to Federal Government: $176,653

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: 05/31/2023

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