Acquisition Services Information Requirements

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1600-04 FDIC Background Investigation Questionnaire for Contractor Personnel and Subcontractors	Form and Instruction	Unchanged	Available
Form 1600-04 Background Investigation Questionnaire for Contractor Personnel and Subcontractors (Form 1600/04)	Form and Instruction	Unchanged	Repair queued
Form 1600/10 Notice and Authorization for Consumer Reports	Form and Instruction	Unchanged	Available
Form 1600/10 Background Investigation Questionnaire for Contractors (Form 1600/10)	Form and Instruction	Unchanged	Repair queued
Form 3700/04A Contractor Representations and Certifications	Form and Instruction	Unchanged	Available
Form 3700/04A Contractor Representations and Certifications (Form 3700/04A)	Form and Instruction	Unchanged	Repair queued
Form 3700/44 Leasing Representations and Certifications	Form and Instruction	Modified	Available
Form 3700/44 Leasing Representations and Certifications (Form 3700/44)	Form and Instruction	Modified	Repair queued
Form 3700/57 Past Performance Questionnaire	Form and Instruction	Unchanged	Available
Form 3700/57 Past Performance Questionnaire (Form 3700/57)	Form and Instruction	Unchanged	Repair queued
Form 3700/12 Integrity and Fitness Representations and Certifications	Form and Instruction	Modified	Available
Form 3700/12 Integrity and Fitness Representations (Form 1600/12)	Form and Instruction	Modified	Repair queued
Form 1600/07 Background Investigation Questionnaire for Contractors	Form and Instruction	Unchanged	Repair queued
Form 1600/07 Background Investigation Questionnaire for Contractors (Form 1600/07)	Form and Instruction	Unchanged	Repair queued
3064-0072 Justification for Non-Substantive Forms Revision Procurement Certs 2023 Certifications.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-08-08	Repair queued
SPST 0072 -Procurement 2022.docx	Supporting Statement A	Uploaded 2022-01-20	Repair queued
FR2-0072 Procurement 87 FR 2784 January 19 2022.pdf	Supplementary Document	Uploaded 2022-01-19	Repair queued
FR1-0072 Procurement 86 FR 62530 November 10 2021.pdf	Supplementary Document	Uploaded 2022-01-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
31818	Background Investigation Questionnaire for Contractor Personnel and Subcontractors (Form 1600/04)	Form and Instruction	Unchanged	FDIC Background Investigation Questionnaire for Contractor Personnel and Subcontractors
31818	Background Investigation Questionnaire for Contractor Personnel and Subcontractors (Form 1600/04)	Form and Instruction	Unchanged
251203	Innovation Pilot Program - Proposal		Unchanged
251202	Innovation Pilot Program - Application		Unchanged
251201	Prize Competition - Proposal		Unchanged
251200	Prize Competitions - Applications		Unchanged
234143	Request for Information		Unchanged
234142	Request for Proposal and Price Quotation (includes Basic Safeguards) - Solicitation/Award (Form 3700/55)		Unchanged
219241	Background Investigation Questionnaire for Contractors (Form 1600/10)	Form and Instruction	Unchanged	Notice and Authorization for Consumer Reports
219241	Background Investigation Questionnaire for Contractors (Form 1600/10)	Form and Instruction	Unchanged
187308	Contractor Representations and Certifications (Form 3700/04A)	Form and Instruction	Unchanged	Contractor Representations and Certifications
187308	Contractor Representations and Certifications (Form 3700/04A)	Form and Instruction	Unchanged
185905	Leasing Representations and Certifications (Form 3700/44)	Form and Instruction	Modified	Leasing Representations and Certifications
185905	Leasing Representations and Certifications (Form 3700/44)	Form and Instruction	Modified
185894	Past Performance Questionnaire (Form 3700/57)	Form and Instruction	Unchanged	Past Performance Questionnaire
185894	Past Performance Questionnaire (Form 3700/57)	Form and Instruction	Unchanged
185892	Integrity and Fitness Representations (Form 1600/12)	Form and Instruction	Modified	Integrity and Fitness Representations and Certifications
185892	Integrity and Fitness Representations (Form 1600/12)	Form and Instruction	Modified
185890	Background Investigation Questionnaire for Contractors (Form 1600/07)	Form and Instruction	Unchanged	Background Investigation Questionnaire for Contractors
185890	Background Investigation Questionnaire for Contractors (Form 1600/07)	Form and Instruction	Unchanged

ICR Details

OMB Control No: 3064-0072	ICR Reference No: 202308-3064-003
Status: Historical Active	Previous ICR Reference No: 202111-3064-001
Agency/Subagency: FDIC	Agency Tracking No: 3064-0072
Title: Acquisition Services Information Requirements
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/16/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/08/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2025	03/31/2025	03/31/2025
Responses	1,993	0	1,993
Time Burden (Hours)	21,234	0	21,234
Cost Burden (Dollars)	0	0	0

---

Abstract: This information collection involves the submission of various forms by (1) contractors who wish to do business with the FDIC or are currently under contract with the FDIC; (2) those vendors and parties participating in innovation pilot programs and prize competitions with the possibility of being awarded a contract; and (3) government agencies or commercial businesses that provide FDIC with past performance information. There is no change in the method or substance of the collection. However, the FDIC has amended this submission to account for the burdens associated with vendors and parties participating in innovation pilot programs and prize competitions.

---

Authorizing Statute(s): US Code: 12 USC 1819 Name of Law: Federal Deposit Insurance Act
   US Code: 12 USC 5452 Name of Law: Dodd-Frank Wall Street Reform and Consumer Protection Act
  

Citations for New Statutory Requirements: US Code: 12 USC 5452 Name of Law: Dodd-Frank Wall Street Reform and Consumer Protection Act

---

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:
	86 FR 62530	11/10/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 2784	01/19/2022
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 13

table that charts list of burden

IC Title	Form No.	Form Name
Background Investigation Questionnaire for Contractor Personnel and Subcontractors (Form 1600/04)	1600-04	FDIC Background Investigation Questionnaire for Contractor Personnel and Subcontractors
Background Investigation Questionnaire for Contractors (Form 1600/07)	1600/07	Background Investigation Questionnaire for Contractors
Background Investigation Questionnaire for Contractors (Form 1600/10)	1600/10	Notice and Authorization for Consumer Reports
Contractor Representations and Certifications (Form 3700/04A)	3700/04A	Contractor Representations and Certifications
Innovation Pilot Program - Application
Innovation Pilot Program - Proposal
Integrity and Fitness Representations (Form 1600/12)	3700/12	Integrity and Fitness Representations and Certifications
Leasing Representations and Certifications (Form 3700/44)	3700/44	Leasing Representations and Certifications
Past Performance Questionnaire (Form 3700/57)	3700/57	Past Performance Questionnaire
Prize Competition - Proposal
Prize Competitions - Applications
Request for Information
Request for Proposal and Price Quotation (includes Basic Safeguards) - Solicitation/Award (Form 3700/55)

---

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	1,993	1,993	0	0	0	0
Annual Time Burden (Hours)	21,234	21,234	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: FDIC is transferring the burden associated with prize competitions and pilot programs where there is the possibility of a contract being awarded from ICR 3064-0211 to this ICR.

---

Annual Cost to Federal Government: $0

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]? Yes

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: 08/08/2023

---