Crisis Assistance Request Form - Niger (Dept. of State)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Justification for Emergency Review - Niger (signed).pdf	Supplementary Document	Uploaded 2023-08-04	Available
Tab 1 - Supporting Statement - Niger Form August 2023.docx	Supporting Statement A	Uploaded 2023-08-02	Available
Tab 1 - Supporting Statement - Niger Form August 2023.docx	Supporting Statement A	Uploaded 2023-08-02	Repair queued
Justification for Emergency Review - Niger.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-08-02	Available
Justification for Emergency Review - Niger.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-08-02	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
261396	Niger Crisis Form	Other-Public Page	New

ICR Details

OMB Control No: 1405-0258	ICR Reference No: 202308-1405-003
Status: Active	Previous ICR Reference No:
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: Crisis Assistance Request Form - Niger (Dept. of State)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 08/02/2023
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/04/2023
	Date Received in OIRA: 08/02/2023
Terms of Clearance: State will publish 60- and 30-day notices before this emergency approval expires if the agency wishes to continue the collection.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2024	6 Months From Approved
Responses	765	0	0
Time Burden (Hours)	5	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: NA

Emergency Justfication: This collection is essential to the mission of the Department of State, which has no higher priority than the safety and welfare of U.S. citizens overseas. The purpose of the collection is to enable the Department to better communicate with U.S. citizens and LPRs who are in need of assistance in departing Niger.

---

Authorizing Statute(s): None

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

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
Niger Crisis Form

---

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	765	0	0	765	0	0
Annual Time Burden (Hours)	5	0	0	5	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: The Department will use this online form to acquire the most current and accurate data possible to inform our consular assistance efforts. It will allow us to build a true and timely picture of how many U.S. citizens plan to remain in Niger and any who may need reimbursable loan assistance to depart affected areas and/or return to the United States. The online form helps avoid unstructured requests for assistance, such as those that arrive via e-mail messages or via social media. These ad hoc efforts may not include important information, such as family size and the requestor’sir biodata, and which often require entry into other systems to facilitate responses. The proposed online assistance request form is integrated with other elements of the Department’s evolving information technology platform used in crisis-management situations, enhancing the efficient handling of individual cases.

---

Annual Cost to Federal Government:

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: 08/02/2023

---