Consultation Request Form

Forms and Documents

Document Name	Status
Form 018 DFC Consultation Request Form Form	New
DFC-018 - 83-I Questionairre for OMB.pdf Supplementary Document	2024-11-26
DFC-018 - Supporting Statement.docx Supporting Statement A	2024-11-26

IC Document Collections

IC ID	Document Title	Status
272685	DFC Consultation Request Form Form	New

ICR Details

OMB Control No:	ICR Reference No: 202411-3015-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: DFC	Agency Tracking No: DFC-018
Title: Consultation Request Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/02/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	850	0
Time Burden (Hours)	213	0
Cost Burden (Dollars)	15,938	0

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Abstract: The Consultation Request Form will be the principal document used by the agency’s business development officers to record inbound, unsolicited leads and prospects in its customer relationship management (CRM) database to better track and report on market interest by sector and geography, as well as ensure that leads are evaluated through single channels and minimize duplication of business development efforts.

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Authorizing Statute(s): PL: Pub.L. 115 - 254 1 Name of Law: Build Act
  

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 67613	08/21/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 37347	11/01/2024
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
DFC Consultation Request Form	018	Consultation Request Form

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ICR Summary 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	850	0	0	850	0	0
Annual Time Burden (Hours)	213	0	0	213	0	0
Annual Cost Burden (Dollars)	15,938	0	0	15,938	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: Entered initial data incorrectly. This is a new form.

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Annual Cost to Federal Government: $14,192

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: 12/02/2024

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