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173997700
ICR 202610-0923-001 · OMB 0923-0057 · Object 173997700.
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| File Title | 173997700 |
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| Last Modified By | texttopdf/2.0.0 |
| File Modified | 2026-10-20 |
| File Created | 2026-10-21 |
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APPLETREE Performance Measures OMB Control No. 0923-0057 Expiration Date 10/31/2026 Revision Information Collection Request Supporting Statement Part A – Justification Project Officer: Audra Henry Title: Health Scientist Phone: 770-488-3758 Email: [email protected] Date: September 15, 2026 Table of Contents A.1. Circumstances Making the Collection of Information Necessary 3 A.2. Purpose and Use of the Information Collection 4 A.3. Use of Improved Information Technology and Burden Reduction 8 A.4. Efforts to Identify Duplication and Use of Similar Information 8 A.5. Impact on Small Businesses or Other Small Entities 8 A.6. Consequences of Collecting the Information Less Frequently 9 A.7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5 9 A.8. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency 9 A.9. Explanation of Any Payment or Gift to Respondents 9 A.10. Protection of the Privacy and Confidentiality of Information Provided by Respondents 10 A.11. Institutional Review Board (IRB) and Justification for Sensitive Questions 10 A.12. Estimates of Annualized Burden Hours and Costs 10 A.13. Estimates of Other Total Annual Cost Burden to Respondents and Record Keepers 15 A.14. Annualized Cost to the Federal Government 15 A.15. Explanation for Program Changes or Adjustments 16 A.16. Plans for Tabulation and Publication and Project Time Schedule 18 A.17. Reason(s) Display of OMB Expiration Date is Inappropriate 18 A.18. Exceptions to Certification for Paperwork Reduction Act Submissions 19 Part A. Justification A.1. Circumstances Making the Collection of Information Necessary The purpose of the ATSDR’s Partnership to Promote Local Efforts to Reduce Environmental Exposure (APPLETREE) Program is to: 1) identify pathways of exposure to hazardous substances at hazardous waste sites and releases; 2) identify, implement, and coordinate public health interventions to reduce exposures to hazardous substances which occur at levels of health concern; and 3) provide training at the state level to promote and achieve the safe siting of child care facilities in the United States. The APPLETREE program strengthens ATSDR's coordination and communication with federal, state, and local health and environmental agencies. The APPLETREE Program is authorized under Sections 104(i)(15) of the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) of 1980, as amended by the Superfund Amendments and Reauthorization Act (SARA) of 1986 [42 U.S.C. 9604(i)(15)] (Attachment 1). On October 3, 2022, the Agency for Toxic Substances and Disease Registry (ATSDR) published the notice of funding opportunity announcement (NOFO No. CDC-RFA-TS-23-0001) for the APPLETREE Program (Attachment 3). Under the current five-year cooperative agreement, ATSDR will continue to collect information related to APPLETREE recipients’ activities, including process and outcome performance measures. ATSDR will continue to use this information to monitor progress toward program goals and objectives and for program quality improvement. A.2. Purpose and Use of the Information Collection The purpose of this ICR is to support program planning and management related to recipient progress reporting, financial reporting and grants management, and quality control. Throughout the current five-year APPLETREE program cycle, ATSDR utilizes this information to monitor recipient performance and provide technical support in environmental assessment, community engagement, education, and stakeholder communication at ATSDR-related sites. Recipients may participate in ATSDR’s Choose Safe Places for Early Care and Education (CSPECE) which is a safe siting program for childcare facilities. This participation will foster a systematic way to work with childcare licensing authorities to evaluate prospective childcare locations, train licensing authorities, and evaluate existing childcare locations. As outlined in the NOFO, the specific short-term, intermediate, and long-term outcomes and performance measures for the APPLETREE program are presented below. Short-term, Intermediate, and Long-term Outcomes 1.1 Timely dissemination of site-specific findings to partners, stakeholders, and community members. (Component 1, Strategy A) 1.2 Increased partner buy-in and acceptance of recommendations. (Component 1, Strategy A) 1.3 Increased buy in and support from broad array of partners. (Component 1, Strategy B) 1.4 Increased stakeholder/partners knowledge of ECE siting issues and recommendations to prevent exposure. (Component 1, Strategy B) 1.5 Increased understanding of barriers and facilitators for safe siting. (Component 1, Strategy B) 1.6 Enhanced and/or expanded CSPECE programs. (Component 1, Strategy B) 1.7 Enhanced infrastructure among partners to sustain CSPECE program. (Component 1, Strategy B) 1.8 Increased knowledge among target audience to identify, reduce, or prevent health effects from exposure to hazardous substances. (Component 2) 2.1 Increased implementation of recipient recommendations to reduce, eliminate, or prevent exposures by regulatory agencies, policy makers, and/or individuals. (Component 1, Strategy A) 2.2 Decreased or eliminated site-related exposures. (Component 1, Strategy A) 2.3 Increased stakeholder practices to reduce hazardous exposure among children. (Component 1, Strategy B) 2.4 Increased process, systems, and policy changes to support exposure prevention. (Strategy B) 2.5 Increased practices of partners to manage CSPECE program independently. (Component 1, Strategy B) 2.6 Increased actions among target audience to identify, reduce, or prevent health effects from exposure to hazardous substances. (Component 2) 3.1 Decreased, eliminated, or prevented exposures to hazardous chemicals. (all Strategies for Component 1 and 2) 3.2 Increased collection of evidence on effective practices, policies, and processes for preventing exposure (all Strategies for Component 1 and Component 2) The following information collection forms collect process and outcome measures relevant to activities and outcomes for which the recipients are accountable for tracking. All forms were previously approved by OMB in 2023. 1. ATSDR Health Education (HE) Activity Form (Attachment 4a): For health education activities, APPLETREE recipients shall quantitatively assess and report efforts to educate community members about site recommendations and health risks using indicators to assess community understanding of site findings about health risks and community understanding of agency recommendations to reduce health risks. This information will be entered into ARMSS. 2. ATSDR Technical Assistance (TA) Activity Form (Attachment 4b): Throughout the budget year, this form will be used to record the routine requests made by the recipients and their program responses. These responses do not evaluate environmental data and do not make health calls. They are not reviewed and cleared through ATSDR clearance processes but are monitored by ATSDR as part of the recipients’ performance. This information will be entered into ARMSS. 3. ATSDR Site Impact Assessment (SIA) Form (Attachment 4c): For each environmental health assessment conducted at ATSDR sites, recipients shall estimate and report the number of people protected from exposure to toxic substances at each site where implementation of agency recommendations has taken place. To the extent possible, recipients shall estimate the disease burden prevented due to the implementation of site recommendations. This information will be entered into ARMSS. 4. ATSDR Success Story Form (Attachment 4d): Recipients will provide a minimum of one success story per quarter (four success stories total per year) that highlights an impact of any of their programs. Recipients will report a brief summary, background, intervention/action taken, and accomplishment/impact for each story. Optionally, they may include a photo or quote. This information will be entered into ARMSS. 5. APPLETREE Annual Performance Report (APR) Template (Attachment 4e) and Guidance Document (Attachment 4e1): Recipients will continue to provide an APR each year and at the end of the funding cycle, which summarizes their annual and funding cycle performances, respectively. Annual APRs will be due in November of each year to coincide with the CDC Grants Management annual reports to reduce the overall reporting burden. The final report will be due at the end of the funding cycle. The purpose of the performance reports will be to assess recipients based on performance measures and evaluation projects. Reports include a summary of performance measures, findings from evaluation projects, an updated work plan, and a narrative detailing progress, successes, challenges, and interpretations of results. These reports will continue to be entered into a Microsoft Word document and provided directly to ATSDR via email. 6. CSPECE Qualitative Narrative Form (Attachment 4f): Recipients will provide a narrative report of their Choose Safe Places for Early Care and Education (CSPECE) Programs to document descriptive details of their state’s landscape, program plan, program implementation, and results that cannot be captured through numbers. Recipients will complete and submit the narrative once a year and at the end of the grant cycle as a supplement with their Annual Performance Reports in a Microsoft Word document and provide directly to ATSDR via email. 7. CSPECE Quantitative Form (Attachment 4g): Recipients will provide data on their CSPECE Programs to quantify aspects of their program such as children reached, target audiences educated, early care and education programs referred and screened, and recommendations implemented. Recipients will complete and submit a Microsoft Excel form once a year and at the end of the grant cycle as a supplement with their Annual Performance Reports and provide directly to ATSDR via email. The form is cumulative and documents efforts from all five years. 8. ATSDR SoilSHOP Form (Attachment 4h): SoilSHOPs are not a required activity, however if a recipient completes a SoilSHOP, they need to complete a SoilSHOPs Form in Word. This form gathers data on the inputs, activities, outputs, and outcomes of the event, such as the number of soil samples screened, number of elevated soil samples, number of individuals receiving health consultations, and number of individuals receiving referrals. The form should be provided back to ATSDR via email within a month of a SoilSHOP completion. 9. ATSDR Recommendation Follow-up Form (Attachment 4i): For each environmental health assessment, recipients will provide an update on the status of acceptance and implementation of all recommendations to understand whether and how recommendations have been implemented, and the subsequent impact on communities. Recipients will complete an Excel reporting form annually on the anniversary date of the release of each health assessment. Recipients will provide to ATSDR via email. 10. ATSDR Requests Form (Attachment 4j): For each environmental health assessment, recipients will provide the request, dates, and triage information and can associate the request with a hazardous waste site. Site scoping and clearance information are completed for about 15% of environmental health assessments that complete ATSDR’s clearance process (i.e., certified). This information will be entered into ARMSS. A.3. Use of Improved Information Technology and Burden Reduction Only the minimum amount of necessary information will be collected for the “APPLETREE Performance Measures” ICR. ATSDR will require recipients to electronically submit the HE, the TA, SIA Performance Measures, Requests, and Success Stories in ARMSS. The use of this electronic reporting system will reduce recipient burden because the information can be submitted directly and quickly into the ATSDR system. The estimated time for each entry is 4, 4, and 7 minutes for HE, TA, and SIA, respectively. Direct entry will also reduce transcription errors because recipients will not have to send the information in another reporting form requiring separate data entry at ATSDR. We estimate that 58% (157/269) of the requested burden hours will be spent reporting electronically in ARMSS. All other forms, including the APR, the SoilSHOP Form, the Recommendation Follow-up Form, and both CSPECE forms, will be submitted in electronic format to ATSDR via email. We estimate that 42% (112/269) of the requested burden hours will be spent reporting by submitting reports via email to ATSDR. A.4. Efforts to Identify Duplication and Use of Similar Information There will be no duplication of program management information in the APPLETREE Program. The reported information from the recipient will be generated as site activities progress throughout the budget year. No similar information exists. A.5. Impact on Small Businesses or Other Small Entities Recipient reports or performance measures and annual reports will not involve small businesses. A.6. Consequences of Collecting the Information Less Frequently APPLETREE recipients will submit information about each site activity into the HE, TA, SIA, SoilSHOP, and Requests forms as they occur. Due to the high volume of ATSDR site activities anticipated per year, we estimate each recipient will submit information several times per year. This frequency is necessary for accurate tracking of site activities. To allow recipients to wait to submit activity summaries monthly, quarterly, biannually, or annually, would result in loss of detail in site activities and increased opportunity for recall bias. This high volume of entries is offset by the minimal time needed to enter each site activity. The APPLETREE recipients will submit APRs and both CSPECE forms once per year for program management and monitoring. Reporting once per year is a minimum requirement. Additionally, each form will be submitted a 6th time at the end of the period of performance. There are no technical or legal obstacles to reducing burden. A.7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5 The following special circumstance(s) apply to this information collection. We are requiring the APPLETREE recipients to report HE, TA, SIA, SoilSHOP, and Requests information to the agency more often than quarterly as described and justified in Section A.6. A.8. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency A. A 60-day Federal Register Notice was published in the Federal Register on 06/26/2026, Vol. 91, No. 122, pp. 38712 (Attachment 2). ATSDR received one public comment (Attachment 2a) related to this notice. Response to comment is included (Attachment 2b). B. The APPLETREE Program has been in existence since 1987. As a mature program, consultations outside of ATSDR did not occur during the preparation of this NOFO (Attachment 3). A.9. Explanation of Any Payment or Gift to Respondents No payment or gift to APPLETREE recipients will be offered. The recipients are required to submit reports and performance measures as part of the cooperative agreement. A.10. Protection of the Privacy and Confidentiality of Information Provided by Respondents APPLETREE collection instruments collect the recipient Point of Contact (POC) name, phone number and email. On 03/05/2020, the CDC Chief Privacy Officer determined that the Privacy Act does not apply to the APPLETREE ICR, as records will not be retrieved by POC identifiers. The APPLETREE Program will collect recipient performance measures using CDC approved systems. These systems comply with all security and privacy controls required by the Federal Information Security Modernization Act (FISMA) to protect the information collected. Records collected under this ICR will be maintained in accordance with CDC/ATSDR Records Control Schedule. A.11. Institutional Review Board (IRB) and Justification for Sensitive Questions The APPLETREE Program is conducted under the non-research cooperative agreement (NOFO No. CDC-RFA-TS-23-0001) (Attachment 3). The ATSDR Human Subjects Contact has determined that the information collection is necessary for program management and is not research. Institutional Review Board (IRB) approval is not required (Attachment 6). Sensitive information will not be reported to ATSDR. A.12. Estimates of Annualized Burden Hours and Costs A. The total number of annualized burden hours requested is 336 hours. Details about the requested revisions are found in Section A.15. Current estimates of burden hours for each information collection (IC) were derived as follows: a. ATSDR Health Education Activity (HE) Form: For each environmental health assessment and health education activity conducted at ATSDR sites, APPLETREE Recipients shall quantitatively assess and report efforts to educate community members about site recommendations and health risks using indicators to assess community understanding of site findings about health risks and community understanding of agency recommendations to reduce health risks. This information will be entered into ARMSS. Based on 2025 activities, ATSDR estimates a maximum of 500 health education activities. Each of the 30 recipients will enter an average of 17 activities into ARMSS, resulting in 34 total burden hours per year and 102 hours over the length of the ICR. See Attachment 4a. b. ATSDR Technical Assistance (TA) Activity Form: Throughout the budget year, this form will be used to record the routine requests made by the recipients and their program responses. These responses do not evaluate environmental data and do not make health calls, but they are monitored by ATSDR as part of the recipients’ performance. Based on 2025 activities, ATSDR assumes a maximum of 500 TA activities. Each of the 30 recipients will enter an average of 17 activities into ARMSS, resulting in 34 total burden hours per year and 102 hours over the length of the ICR. See Attachment 4b. c. ATSDR Site Impact Assessment (SIA) Form: For each environmental health assessment and health education activity conducted at ATSDR sites, recipients shall estimate and report the number of people protected from exposure to toxic substances at each site where implementation of agency recommendations has taken place and at each childcare center where safe siting guidelines have been implemented. To the extent possible, recipients shall estimate and report the disease burden prevented due to the implementation of site recommendations and safe siting guidelines. Based on 2025 activities, ATSDR estimates a maximum of 85 sites will undergo an environmental assessment, an average of 3 sites per recipient. This will result in 11 total burden hours per year and 33 hours over the length of the ICR. See Attachment 4c. d. ATSDR Success Story Form: Recipients will provide one success story per quarter (four success stories total per year) that highlights the impact of any of their programs. Recipients will report a brief summary, background, intervention/action taken, and accomplishment/impact for each story. Optionally, they may include a photo or quote. ATSDR estimates that each entry will take one hour. This equates to 120 burden hours per year and 360 hours over the length of the ICR. See Attachment 4d. e. APPLETREE Annual Performance Report (APR) Template: Recipients will provide an Annual Performance Report each year and at the end of the grant cycle, which summarizes their annual and grant cycle performances respectively. APRs will be due in November of each year to coincide with the CDC Grants Management annual reports to reduce the overall reporting burden, and the final report will be due at the end of the funding cycle. The purpose of the performance reports will be to assess recipients based on performance measures and evaluation projects. Reports include a summary of performance measures, findings from evaluation projects, an updated work plan, and a narrative detailing progress, successes, challenges, and interpretations of results. ATSDR estimates that APRs will take 2 hours for each recipient to prepare, resulting in 60 burden hours per year and 180 hours over the length of the ICR. See Attachment 4e.1 ATSDR provides the APR Guidance Document for recipients in Attachment 4e1. f. Choose Safe Places for Early Care and Education (CSPECE) Qualitative Narrative Form: Recipients will complete and submit the narrative once a year and at the end of the grant cycle as a supplement with their APRs to document descriptive details of their state’s landscape, program plan, program implementation, and results that cannot be captured through numbers. ATSDR estimates it will take 1 hour per response for 30 burden hours each year and 90 hours over the length of the ICR. See Attachment 4f.1 g. CSPECE Quantitative Form: Recipients will complete and submit the quantitative spreadsheet once a year and at the end of the grant cycle as a supplement with their APRs to quantify aspects of their program such as children reached, target audiences screened, and recommendations implemented. ATSDR estimates it will take 30 minutes per response for 15 burden hours each year and 45 hours over the length of the ICR. See Attachment 4g.1 h. ATSDR SoilSHOP Form: SoilSHOPs are not a required activity; however, if conducted, a recipient will need to complete the ATSDR SoilSHOP Form. This form gathers data on the inputs, activities, outputs, and outcomes of the event, such as the number of soil samples screened, the number of elevated soil samples, the number of individuals receiving health consultations, and the number of individuals receiving referrals. The form should be provided back to ATSDR via email within a month of the SoilSHOP completion. Based on 2025 activities, ATSDR estimates that ten recipients will participate in a SoilSHOP event. This will result in 1 total burden hour each year and 3 hours over the length of the ICR. See Attachment 4h. i. ATSDR Recommendation Follow-up Form: For each environmental health assessment, recipients will provide an update on the status of acceptance and implementation of all recommendations to understand whether and how recommendations have been implemented, and the subsequent impact on communities. Recipients will complete this reporting form annually on the anniversary date of the release of each health assessment. ATSDR expects that recommendation follow-up will be necessary 4 times per year per recipient. ATSDR estimates that each response will take 10 minutes for a total burden of 20 hours each year and 60 hours over the length of the ICR. See Attachment 4i. j. ATSDR Requests Form: For each environmental health assessment, recipients will provide the request, dates, and triage information and can associate the request with a hazardous waste site. Site scoping and clearance information are completed for about 15% of environmental health assessments that complete ATSDR’s clearance process (i.e., certified). This information will be entered into ARMSS. Based on 2022 activities, ATSDR estimates a maximum of 85 sites will undergo an environmental assessment, an average of 3 sites per recipient. This will result in 11 total burden hours per year and 33 hours over the length of the ICR. See Attachment 4j. Table A.12.1. Estimated Annualized Burden Hours Type of Respondents Form Name No. of Respondents No. of Responses per Respondent Avg. Burden per Response (in hrs.) Total Burden (in hours) APPLETREE Recipients ATSDR Health Education (HE) Activity Form 30 17 4/60 34 ATSDR Technical Assistance (TA) Activity Form 30 17 4/60 34 ATSDR Site Impact Assessment (SIA) Form 30 3 7/60 11 ATSDR Success Story Form 30 4 1 120 APPLETREE Annual Performance Report (APR) Template 30 1 2 60 Choose Safe Places for Early Care and Education (CSPECE) Qualitative Narrative Form 30 1 1 30 CSPECE Quantitative Form 30 1 30/60 15 ATSDR SoilSHOP Form 10 1 7/60 1 ATSDR Recommendation Follow-up 30 4 10/60 20 ATSDR Requests 30 3 7/60 11 Total 336 B. Estimates of the annualized cost burden to respondents for the collection of information are based on the Department of Labor Bureau of Labor Statistics “May 2025 National Occupational Employment and Wage Statistics, United States” (see http://www.bls.gov/oes/current/oes_nat.htm#19-0000). Table A.12.2. Hourly Wage Estimates for APPLETREE Recipients Occupation Code Occupation Title Mean Hourly Wage 19-2041 Environmental Scientists and Specialists, Including Health $44.08 * Conduct research or perform investigation for the purpose of identifying, abating, or eliminating sources of pollutants or hazards that affect either the environment or the health of the population. Using knowledge of various scientific disciplines, may collect, synthesize, study, report, and recommend action based on data derived from measurements or observations of air, food, soil, water, and other sources. Table A.12.3. Estimated Annualized Burden Costs Type of Respondent Form Name Total Burden Hours Hourly Wage Rate Total Respon-dent Costs Wage Rate Multi-plier Fully-Loaded Cost Burden APPLETREE Recipients ATSDR Health Education Activity (HE) Form 34 $44.08 $1,498.72 x 2 $2,997.44 ATSDR Technical Assistance (TA) Activity Form 34 $44.08 $1,498.72 x 2 $2,997.44 ATSDR Site Impact Assessment (SIA) Form 11 $44.08 $484.88 x 2 $969.76 ATSDR Success Story Form 120 $44.08 $5,289.60 x 2 $10,579.20 APPLETREE Annual Performance Report (APR) Template 60 $44.08 $2,644.80 x 2 $5,289.60 CSPECE Qualitative Narrative Form 30 $44.08 $1,322.40 x 2 $2,644.80 CSPECE Quantitative Form 15 $44.08 $661.20 x 2 $1322.40 ATSDR SoilSHOP Form 1 $44.08 $44.08 x 2 $88.16 ATSDR Recommendation Follow-up 20 $44.08 $881.60 x 2 $1,763.20 ATSDR Requests 11 $44.08 $484.88 x 2 $969.76 Total $14,810.88 $29,621.76 A.13. Estimates of Other Total Annual Cost Burden to Respondents and Record Keepers Capital and start-up costs will not be required for APPLETREE recipients. A.14. Annualized Cost to the Federal Government The total annualized cost to the Federal Government is $14,715,384 based on the yearly costs itemized below. • The project funding for the five-year cooperative agreement is $69,750,000, or $13,950,000 per year. • Annual salary for 3 Technical Project Officers is $382,692, based on an annual salary of $127,564 per GS-13 staff 2 A wage rate multiplier of x2 generates a total of $765,384. A.15. Explanation for Program Changes or Adjustments The requested annualized burden hours have increased by 67 hours from the 2023 revision, totaling 336 hours. There have been no significant changes in the content of the forms. The calculation of the amount of time to fill out the forms has been adjusted. This accounts for the increase in burden hours. Table A.15.1. Program Changes and Adjustments for Requested Time Burden. Form Name 2023 Approval Status Current Request Mode of Collection Attachment 4a - ATSDR HEAT Form Approved 34 hours No change ARMSS Attachment 4b – ATSDR TA Activity Form Approved 34 hours No change Attachment 4c – ATSDR SIA Form Approved 11 hours No change Attachment 4d – ATSDR Success Story Form Approved 60 hours 120 hours ARMSS Attachment 4e – APPLETREE APR Template Approved 60 hours No change Word document via email Attachment 4f – CSPECE Qualitative Narrative Form Approved 30 hours No change Word document via email Attachment 4g – CSPECE Quantitative Form Approved 8 hours 15 hours Excel file via email. Attachment 4h – ATSDR SoilSHOP Form Approved 1 hour No change. SoilSHOPs are not a mandatory program requirement for all recipients. Request 1 total hour, reported by subset of 10 recipients, only if they choose to conduct a SoilSHOP. Word document via email. Attachment 4i – ATSDR Recommendation Follow-up Form Approved 20 hours No change Excel file via email. Attachment 4j – ATSDR Requests Form Approved 11 hours No change ARMSS A.16. Plans for Tabulation and Publication and Project Time Schedule ATSDR requests PRA clearance for three years. ATSDR requests approval by 11/02/2026 as a critical date by which information collection must begin. Several forms require year-round reporting. Each budget year, recipients must submit an initial annual plan of work (APOW) via the application process, SoilSHOP, HEAT, TA, SIA, Requests, and Success Stories database entries throughout, and APRs (including updated APOWs), CSPECE Quantitative and Qualitative forms, and Recommendation Follow-up Forms at the end of the budget year. Data on performance measures will be analyzed and presented in a variety of ATSDR products as descriptive statistics. Table A.16.1. Project Time Schedule Activity Time Schedule Date of Awards 4/1/2027, 4/1/2028, 4/1/2029 PRA Clearance Obtained Requested by 11/02/2026 Information Collection and Reporting FY2027 - FY2029 A.17. Reason(s) Display of OMB Expiration Date is Inappropriate The display of the OMB expiration date is appropriate. A.18. Exceptions to Certification for Paperwork Reduction Act Submissions There are no exceptions to the certification.