Employee Polygraph Protection Act

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form WH-1481 Notice to Examinee Applicable to Certain Ongoing Investigations, Security Services, and Security of Controlled Substances	Form	Unchanged	Repair queued
1235 - 0005 Calculations.xlsx	Supplementary Document	Uploaded 2023-06-27	Repair queued
SS 1235-0005 v3.6 (2023-08-31).docx	Supporting Statement A	Uploaded 2023-09-01	Repair queued
60-day FR Notice 1235-0005 (2023-02-28).pdf	Supplementary Document	Uploaded 2023-06-26	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
198519	Test Results Written Report and Test Record Maintenance--Employer		Unchanged
185481	Test Results Written Report and Test Record Maintenance--Polygrapher		Modified
185480	Written Notice of Test Results Prior to Adverse Employment Action		Modified
185476	Notice to Polygraph Examiner Identifying Persons to be Examined		Unchanged
185475	Notice to Examinee--Ongoing Investigations of Employer's Economic Loss or Injury		Unchanged
13874	Notice to Examinee Applicable to Certain Ongoing Investigations, Security Services, and Security of Controlled Substances	Form	Unchanged

ICR Details

OMB Control No: 1235-0005	ICR Reference No: 202306-1235-003
Status: Received in OIRA	Previous ICR Reference No: 202001-1235-001
Agency/Subagency: DOL/WHD	Agency Tracking No:
Title: Employee Polygraph Protection Act
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/08/2023

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	10/31/2023
Responses	757,400	757,400
Time Burden (Hours)	68,739	68,739
Cost Burden (Dollars)	0	0

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Abstract: These third-party notifications and recordkeeping requirements help ensure polygraph examinees receive the protections and rights provided by the Employee Polygraph Protection Act (EPPA).

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Authorizing Statute(s): US Code: 29 USC 2001, et seq. Name of Law: The Employee Polygraph Protection Act of 1988
  

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 12701	02/28/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 62107	09/08/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Notice to Examinee Applicable to Certain Ongoing Investigations, Security Services, and Security of Controlled Substances	WH-1481	Notice to Examinee-Employee Polygraph Protection Act
Notice to Examinee--Ongoing Investigations of Employer's Economic Loss or Injury
Notice to Polygraph Examiner Identifying Persons to be Examined
Test Results Written Report and Test Record Maintenance--Employer
Test Results Written Report and Test Record Maintenance--Polygrapher
Written Notice of Test Results Prior to Adverse Employment Action

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	757,400	757,400	0	0	0	0
Annual Time Burden (Hours)	68,739	68,739	0	0	0	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:

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Annual Cost to Federal Government: $2,427

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.     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

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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: 09/08/2023

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