0 - Privacy Act Checklist

NCEH/ATSDR Office of Science

Privacy Act and Information Collection Request (ICR) Certification Checklists

ICR Name: Distribution of Traceable Opioid Material* Kits (TOM Kits*) across U.S. and International Laboratories

OMB ID: 0920-1313

ICR Classification: Revision

Requested Expiration Date: Three years from approval date

PRIVACY ACT DETERMINATION

On 12/02/2022, the CDC Chief Privacy Officer conducted this review and has determined that the Privacy Act does not apply. Records will not be retrieved by identifiers. A System of Records Notice (SORN) is not required.

1. The respondents may be state or local governments.

2. The responses will not arrive at NCEH/ATSDR with identifiable information.

3. The responses may arrive at NCEH/ATSDR in aggregate form.

4. The data management procedures have not changed since previous approval.

5. The instruments have been through revisions.

ICR CERTIFICATION

The following checklist indicates whether statements on the required elements of certification are addressed in the ICR. For all “NO” responses, indicate whether a justification has been provided in the Supporting Statement(s):

1. (YES) - Necessary for the proper performance of agency functions

2. (YES) - Avoids unnecessary duplication

3. (YES) - Reduces burden on small entities

4. (YES) - Uses plain, coherent, and unambiguous terminology that is understandable to respondents

5. (YES) - Consistent and compatible with current reporting and recordkeeping practices

6. (YES) - Written to indicate the retention period for recordkeeping requirements

7. (YES) - Written to inform respondents of the information called for under 5 CFR 1320.8(b)(3):

   1. (YES) - Why the information is being collected

   2. (YES) - Use of information

   3. (YES) - Burden estimate

   4. (YES) - Nature of response (voluntary, required for a benefit, or mandatory)

   5. (YES) - Nature and extent of confidentiality

   6. (YES) - Need to display currently valid OMB control number

8. (YES) - Developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected

9. (NOT APPLICABLE) - Makes use of effective and efficient statistical survey methodology

10. (YES) - Makes appropriate use of information technology