E-Appeal/U.S. Merit Systems Protection Board Appeal Form

Forms and Documents

Document Name	Status
No Material Changes Form and Instruction	New
Form 185 Initial Appeal Form and Instruction	Unchanged
3124-0~1.PDF Justification for No Material/Nonsubstantive Change	2025-05-27
3124-00xx Supporting Statement (Final).pdf Supporting Statement A	2023-08-09

IC Document Collections

IC ID	Document Title	Status
275476	No Material Changes Form and Instruction	New
261485	Initial Appeal Form and Instruction	Unchanged

ICR Details

OMB Control No: 3124-0017	ICR Reference No: 202505-3124-002
Status: Received in OIRA	Previous ICR Reference No: 202308-3124-001
Agency/Subagency: MSPB	Agency Tracking No:
Title: E-Appeal/U.S. Merit Systems Protection Board Appeal Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/27/2025

	Requested	Previously Approved
Expiration Date	09/30/2026	09/30/2026
Responses	10,000	5,000
Time Burden (Hours)	7,500	7,500
Cost Burden (Dollars)	0	0

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Abstract: The U.S. Merit Systems Protection Board (MSPB or Board) is seeking approval of a new Information Collection Request (ICR) in accordance with the Paperwork Reduction Act (PRA). The ICR will be submitted to the Office of Management and Budget (OMB) for review and clearance. This information collection is part of MSPB’s statutory mission to adjudicate appeals of certain Federal agency personnel and retirement actions and certain alleged violations of law. The information collection instruments consist of the Initial Appeal Form in different collection mediums: paper, Portable Document Format (PDF), and through MSPB’s electronic filing system, e-Appeal. Through this collection and approval process, MSPB is complying with normal clearance procedures. MSPB has a currently approved collection, OMB No. 3124-0009, E-Appeal/U.S. Merit Systems Protection Board Appeal Form, which will be discontinued once this collection has been approved. The Initial Appeal Form (Form 185) for this new collection is substantially similar to the currently approved Initial Appeal Form. Also following approval of this new collection, MSPB will deploy a new, modernized platform for its e-Appeal system that collects the information required to initiate an appeal. Included in this process are collections related to the administration of the appeals process, including point of contact information and technical support request form.

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Authorizing Statute(s): US Code: 5 USC 7701
   US Code: 5 USC 1204
  

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 25026	04/25/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 53929	08/09/2023
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Initial Appeal	185, e-Appeal Online Law Firm Preregistration, e-Appeal Online Registration, e-Appeal Technical Support Request Form, e-Appeal Online Submission	Form 185 ,   e-Appeal Online Law Firm Preregistration ,   e-Appeal Online Registration ,   e-Appeal Online Submission ,   e-Appeal Technical Support Request Form
No Material Changes	N/A, N/A, N/A	Online Registration Changes ,   Technical Support Changes ,   Initial Appeal Form Changes

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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	10,000	5,000	0	5,000	0	0
Annual Time Burden (Hours)	7,500	7,500	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $1,040,729

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: 05/27/2025

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