Awardee Certifications and Disclosures

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Annex G - Awardee Certifications, Assurances, and Representations.pdf	Supplementary Document	Uploaded 2024-08-28	Missing upstream
Award Certifications and Disclosures PRA Supporting Statement A and B Templates_Responses.docx	Supporting Statement A	Uploaded 2024-08-28	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
249067	Awardee Certifications and Disclosures		Modified

ICR Details

OMB Control No: 0417-0501	ICR Reference No: 202408-0417-001
Status: Received in OIRA	Previous ICR Reference No: 202108-0417-001
Agency/Subagency: IAF	Agency Tracking No: IAF-06
Title: Awardee Certifications and Disclosures
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/28/2024

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2024
Responses	450	10
Time Burden (Hours)	90	15
Cost Burden (Dollars)	1,404	230

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Abstract: The IAF works to promote sustainable development in Latin America and the Caribbean by directly supporting civil society organizations through funding actions, such as grants and cooperative agreements. The purpose of this form is to ensure that grantees are complying with the necessary federal laws and regulations to receive federal funds and give grantees an opportunity to disclose any personal or organizational conflicts of interest, or potential for conflicts of interest.

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Authorizing Statute(s): US Code: 22 USC 290f Name of Law: Inter-American Foundation Statute
  

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 51546	06/18/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 68185	08/23/2024
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Awardee Certifications and Disclosures

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	450	10	0	440	0	0
Annual Time Burden (Hours)	90	15	0	75	0	0
Annual Cost Burden (Dollars)	1,404	230	0	1,174	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 total annual burden is an increase from the previously claimed burden because this form adds certifications for various federal laws in addition to the conflict of interest disclosure form. For this reason all grantees, which is approximately 450 annually, will fill out this form regardless of whether the grantee has a conflict to disclose. The previously claimed burden only estimated that 10 grantees would need to disclose a conflict of interest.

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Annual Cost to Federal Government: $1,711

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

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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: 08/28/2024

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