Request for Religious Accommodation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FCC Form 5652 Request for Religious Accomodation	Form	New	Available
Form FCC Form 5652 Federal Government	Form	New	Repair queued
Form FCC Form 5652 Request for Religious Accomodation	Form	New	Available
Form FCC Form 5652 Individuals or Households	Form	New	Repair queued
FCC-5652_SS_final version.docx	Supporting Statement A	Uploaded 2024-01-11	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
264099	Federal Government	Form	New	Request for Religious Accomodation
264099	Federal Government	Form	New
264098	Individuals or Households	Form	New	Request for Religious Accomodation
264098	Individuals or Households	Form	New

ICR Details

OMB Control No: 3060-1324	ICR Reference No: 202312-3060-023
Status: Active	Previous ICR Reference No:
Agency/Subagency: FCC	Agency Tracking No: OWD
Title: Request for Religious Accommodation
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/12/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/11/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2027	36 Months From Approved
Responses	3	0	0
Time Burden (Hours)	8	0	0
Cost Burden (Dollars)	600	0	0

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Abstract: The principal purpose for collecting this information, on FCC Form 5652, is to permit the Federal Communications Commission (FCC) to assess whether individuals are entitled to a religious accommodation. Additionally, this information is being collected and maintained by the FCC to record and track requests for religious accommodation by individuals, their provision, and the disposition of such requests.

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Authorizing Statute(s): US Code: 29 USC 1605 Name of Law: Title VII of the Civil Rights Act of 1964, as amended
  

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 72758	10/23/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 1915	01/11/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Federal Government	FCC Form 5652	Request for Religious Accomodation
Individuals or Households	FCC Form 5652	Request for Religious Accomodation

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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	0	0	3	0	0
Annual Time Burden (Hours)	8	0	0	8	0	0
Annual Cost Burden (Dollars)	600	0	0	600	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: 15. The Commission is reporting program changes/increases to this new information collection. These increases to the total number of respondents of +3, total annual responses +3, total annual hours +8 and total annual costs by $600 will be added to OMB’s Active Inventory.

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Annual Cost to Federal Government: $2,271

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: 01/11/2024

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