Workplace Violence Prevention and Response Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Ocean Acidification Post-Cruise Survey	Form and Instruction	New	Repair queued
Workplace Culture Survey	Form and Instruction	New	Repair queued
SASH Data Collection Form	Form and Instruction	New	Repair queued
Impacted Person Reporting Election Form	Form and Instruction	New	Available
0648-WVPR 30-day 88 FR 60933 2023-0906.pdf	Supplementary Document	Uploaded 2023-09-06	Available
0648-WVPR 60-day 87 FR 79279 2022-1227.pdf	Supplementary Document	Uploaded 2023-09-06	Available
0648-WVPR Supporting Statement Part A.docx	Supporting Statement A	Uploaded 2023-08-29	Repair queued
0648-WVPR Supporting Statement Part B.docx	Supporting Statement B	Uploaded 2023-08-29	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
261876	Ocean Acidification Post-Cruise Survey	Form and Instruction	New
261875	Workplace Culture Survey	Form and Instruction	New
261874	SASH Data Collection Form	Form and Instruction	New
261873	Impacted Person Reporting Election Form	Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202308-0648-004
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: DOC/NOAA	Agency Tracking No: 0648-WVPR
Title: Workplace Violence Prevention and Response Forms
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/06/2023

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	323	0
Time Burden (Hours)	237	0
Cost Burden (Dollars)	0	0

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Abstract: This is a request for a new information collection. This information collection will be used to document elements of the sexual assault/sexual harassment (SASH) response and/or reporting process and comply with procedures set up to effectively manage National Oceanic and Atmospheric Administration (NOAA), Workplace Violence Prevention and Response (WVPR). NOAA will also use this collection to survey federal employees, contractors, affiliates, interns, volunteers, or other individuals who work in or visit NOAA-occupied facilities, vessels, or aircraft to determine their perceptions of incidents of SASH, pursuant to NOAA Administrative Order (NAO) 202-1106, Section 5.01e, beginning with the Fisheries Observer population identified as NOAA’s most at risk group.

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Authorizing Statute(s): US Code: 33 USC 894 Name of Law: Actions to address sexual harassment at National Oceanic and Atmospheric Administration
  

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 79279	12/27/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 60933	09/06/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Impacted Person Reporting Election Form	N/A	Impacted Person Reporting Election Statement
Ocean Acidification Post-Cruise Survey	N/A	Ocean Acidification Post-Cruise Survey
SASH Data Collection Form	N/A	SASH Data Form
Workplace Culture Survey	N/A	Workplace Culture Survey

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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	323	0	0	323	0	0
Annual Time Burden (Hours)	237	0	0	237	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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 information collection.

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Annual Cost to Federal Government: $204,612

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 09/06/2023

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