FLO Professional Development Fellowship (PDF) Application

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DS-4297 Professional Development Fellowship Application	Form and Instruction	Modified	Available
Form DS-4297 FLO Professional Development Fellowship (PDF) Application	Form and Instruction	Modified	Missing upstream
12424_PublishedFR_06-07-2024.pdf	Supplementary Document	Uploaded 2024-06-13	Repair queued
12360_PublishedFR_03-25-2024.pdf	Supplementary Document	Uploaded 2024-06-13	Repair queued
LegalAuthorities_GCLO_May 2024.docx	Supplementary Document	Uploaded 2024-06-13	Repair queued
Supporting Statment_GCLO_May 2024_final.docx	Supporting Statement A	Uploaded 2024-06-13	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
229600	FLO Professional Development Fellowship (PDF) Application	Form and Instruction	Modified	Professional Development Fellowship Application
229600	FLO Professional Development Fellowship (PDF) Application	Form and Instruction	Modified

ICR Details

OMB Control No: 1405-0229	ICR Reference No: 202406-1405-003
Status: Historical Active	Previous ICR Reference No: 202112-1405-001
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: FLO Professional Development Fellowship (PDF) Application
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/23/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/13/2024
Terms of Clearance:

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	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2027	36 Months From Approved
Responses	265	0	0
Time Burden (Hours)	729	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: FLO needs the information collected in the PDF application to determine who will receive a Professional Development Fellowship. The information is provided to selection committees that use a set of criteria to score the applications. Respondents are spouses and partners of direct-hire U.S. government employees from all agencies serving overseas under Chief of Mission who want to maintain, enhance, and/or develop professional skills while overseas. The information is sought pursuant to 22 U.S.C. § 2651a– Organization of the Department of State, 22 U.S.C. § 3921- Management of the Foreign Service.

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Authorizing Statute(s): None

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:
	89 FR 20748	03/25/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 48701	06/07/2024
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

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IC Title	Form No.	Form Name
FLO Professional Development Fellowship (PDF) Application	DS-4297	Professional Development Fellowship Application

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ICR Summary of Burden

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	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	265	0	0	5	0	260
Annual Time Burden (Hours)	729	0	0	14	0	715
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: See supporting statement.

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Annual Cost to Federal Government: $18,686

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:  Yes

Description/Changes for Common Form Usage:  Correction of typographical errors to our currently approved collection by inserting/deleting the red text below: • Page 1: Above the “initial” box: “…. I consent to the publication of my name by the Department of State as a recipient…..” • Page 1: “Employee Sponsor Post(s) of Assignment during PDF Period” • Page 3 “Link to Project Cost” • Page 4: Remove extra space after asterisk: * Maximum; • Page 4: Add space between “to” and “average” found in “Paperwork Reduction Act Statement” • Page 4: Add new office name to the Authorities statement under the Privacy Act Statement: (Establishment of the Family Liaison Office, renamed Global Community Liaison Office in 2021) • Page 4: In the Purpose statement: “….Professional Development Fellowships to Eligible Family Members spouses and Members of Household partners of employees of ….” Removal of honorific title field as the information is not needed: • Page 1: Removal of the honorific title field of “Mr./Mrs./Miss”

Approved RCFs using this ICR

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Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 06/13/2024

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