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Paperwork Reduction Act (PRA) �
Guide �
Version 2.0

April 2011 �

Paperwork Reduction Act (PRA) Guide

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Table of Contents
1.
1.1
1.2
1.3.

INTRODUCTION ..................................................................................1
Purpose ................................................................................................1
Scope and Applicability .........................................................................1
Compliance, Enforcement, and Exceptions ..........................................1

RESPONSIBILITIES.............................................................................2

INFORMATION COLLECTION POLICIES AND PROCEDURES ........4
3.1
What Is a “Collection of Information”? ...................................................4
3.1.1
Surveys........................................................................................5
3.2
What Information Collections Require OMB Clearance? ......................5
3.3
What Is Not Considered To Be “Information” Under the PRA? .............6
3.4
Overview of the PRA Process At OPM .................................................7
3.5
Information Collection Request (ICR) Approval Process Timeline ........7
3.6
Information Collection Request (ICR) Requirements ............................8
3.7
Collection Instrument Requirements .....................................................9
3.8
Federal Register Notice Requirements .................................................9
3.8.1
60-Day Federal Register Notice .................................................10
3.8.2
30-Day Federal Register Notice .................................................10
3.8.3
Request for Emergency Clearance of an Information Collection
and Emergency Federal Register Notice ...................................11
3.9
Supporting Statement Requirements ..................................................12
3.10 OPM DMS Procedures .......................................................................12
3.10.1 How to Enter a PRA Clearance Request into DMS....................12
3.10.2 DMS 60-Day Federal Register Notice Requirements.................14
3.10.3 DMS 30-Day Federal Register Notice Requirements.................14
3.10.4 DMS Emergency Clearance Federal Register Notice
Requirements ............................................................................14
3.11 Submitting Information Collection Requests (ICRs) To OMB..............15
3.12 ROCIS Submission Requirements ......................................................15

APPENDIX A: ACRONYMS ...............................................................................17
APPENDIX B: GLOSSARY ................................................................................18
APPENDIX C: REFERENCES ...........................................................................19
C.1 Authorities ...........................................................................................19
C.2 External and Internal Issuances Incorporated by Reference ..............19
C.2.1
External References ..................................................................19
C.2.2
OPM Internal References ..........................................................19
C.2.3
Forms.........................................................................................19
APPENDIX D: SAMPLE 60-DAY FEDERAL REGISTER NOTICE ....................20

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APPENDIX E: SAMPLE 30-DAY FEDERAL REGISTER NOTICE ....................23
APPENDIX F: SAMPLE EMERGENCY FEDERAL REGISTER NOTICE ..........26
APPENDIX G: SAMPLE OMB MEMORANDUM FOR EMERGENCY
CLEARANCE .............................................................................29
APPENDIX H: INSTRUCTIONS FOR COMPLETING OMB FORM 83-I ...........30
APPENDIX I: HOW TO CREATE A SUPPORTING STATEMENT ....................35
APPENDIX J: SAMPLE APPROVED PUBLIC BURDEN STATEMENT ............44

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Revision History
Version
Number
1.0

Version Date

Revision Summary

September 2006

Initial Release

1.1

11/15/2010

Document updated and revised in its entirety

2.0

4/27/2011

Document finalized and published for release.

Executive Summary
The Paperwork Reduction Act (PRA) of 1995 gives the Office of Management and
Budget (OMB) authority over the collection of certain information by Federal agencies.
It is intended, “among other things, to ‘ensure the greatest possible public benefit from
and maximize the utility of information created, collected, maintained, used, shared and
disseminated by or for the Federal Government’ and to ‘improve the quality and use of
Federal information to strengthen decision-making, accountability, and openness in
Government and society.’” See Information Collection under the Paperwork Reduction
Act (April 7, 2010), a Memorandum for the Heads of Executive Departments and
Agencies, and Independent Regulatory Agencies from Cass R. Sunstein, Administrator,
Office of Information and Regulatory Affairs, Office of Management and Budget at
http://www.whitehouse.gov/sites/default/files/omb/assets/inforeg/PRAPrimer_04072010.pdf,
quoting 44 U.S.C. § 3501. The Act requires agencies to plan for the development of
new collections of information and the extension of ongoing collections well in advance
of sending an information collection request to OMB. Agencies must:




Seek public comment on proposed collections of information by placing a notice
in the Federal Register.
Certify to OMB that efforts have been made to reduce the burden of the
collection.
Review and approve information collection requests internally before submitting
them to OMB.

Although the scope of the PRA has changed over the years, its underlying policy
standards remain the same. The PRA seeks to:






Minimize the paperwork burden on the public and other entities.
Ensure the greatest possible public benefit from and maximize the utility of
information created, collected, maintained, used, shared, and disseminated by or
for the Federal Government.
Improve the quality and use of Federal information to strengthen decision making,
accountability, and openness in Government and society.
Minimize the cost to the Federal Government of creating, collecting, maintaining,
using, disseminating, and disposing of information.

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Ensure the integrity, quality, and utility of the Federal statistical system.

All information collections subject to the PRA must be submitted to OMB for approval.
OMB must review and clear the information collection request (ICR) before OPM begins
to collect the information. Clearance must be obtained regardless of whether responding
to the collection is voluntary or mandatory.
The version of this document that is posted to the Web is the official, authoritative
version.

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INTRODUCTION

It is OPM policy to ensure that all information collected from the public adheres to the
requirements of the Paperwork Reduction Act (PRA) of 1995, as amended. All OPM
program offices must determine if an information collection1 requires clearance from the
Office of Management and Budget (OMB) under the PRA and, if it does, obtain OMB
clearance before beginning to collect the information. OPM cannot and will not make
exceptions to legal requirements.
1.1

Purpose

The PRA Guide is designed to assist OPM program offices in determining if an existing
or new information collection meets the requirements of the Paperwork Reduction Act
(PRA) of 1995, as amended by the Clinger-Cohen Act, and in preparing the documents
needed to obtain clearance from the Office of Management and Budget (OMB).
1.2

Scope and Applicability

This guide covers how to determine if an information collection requires clearance under
the PRA, defines the roles and responsibilities of OPM staff for purposes of the PRA, and
details the procedures required to obtain OMB approval to collect the information.
All OPM program offices planning to initiate or extend an information collection must
adhere to the policies and procedures in this guide.
1.3.

Compliance, Enforcement, and Exceptions

Compliance with the PRA Guide is mandatory. Enforcement and monitoring of this
policy is the responsibility of the Chief Information Officer (CIO). The CIO continually
reviews and monitors the status of OPM's information collections by monitoring:


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The effectiveness of the PRA process.
Compliance with existing policies, procedures, standards, and guidelines.
User awareness of the PRA.
Active adoption of the PRA Guide requirements.

Violations of the requirements in the PRA Guide may result in the expiration of an
information collection or the use of an unapproved collection. All expired information
collections are reported to Congress and the President of the United States. Anyone who
violates the requirements also may face administrative action ranging from counseling to
removal from the agency.
Only the OPM PRA Clearance Officer may grant exceptions to the PRA Guide, and only
OMB may grant exceptions to the PRA.
1

See Appendix B, Glossary, for the definition of “information collection.”

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RESPONSIBILITIES

The following stakeholders have responsibilities in implementing this guide:


OPM Director



Chief Information Officer (CIO)



OPM PRA Clearance Officer



Associate Directors (ADs)



Division PRA Coordinators



General Counsel (GC)



Publications Management

2.1

OPM Director

The OPM Director is responsible for providing signature and approval, or assigning a
designee approval and signature authority, for 60-Day and 30-Day Federal Register
Notices.
2.2

Chief Information Officer (CIO)

Responsibilities of the Chief Information Officer (CIO) include:


Ensuring the prompt, efficient, and effective implementation of the information
policies and information collection responsibilities established under the
Paperwork Reduction Act of 1995, as amended.



Establishing a program office to review, evaluate, and process information
collection requests to determine their suitability for submission to OMB.



Providing signature and approval, or assigning a designee approval and signature
authority, for information collection requests before they are submitted to OMB.

2.3

OPM PRA Clearance Officer

Responsibilities of the OPM PRA Clearance Officer include:


Implementing the OPM information collection process to ensure OPM
information collection requests meet OMB requirements.



Providing guidance and assistance to Division PRA Coordinators and program
offices to ensure compliance with the Paperwork Reduction Act of 1995, as
amended.

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

Reviewing and finalizing information collection requests, accompanying
certifications, and documentation before submission to OMB for review and
approval, and to the Federal Register for the publishing of the 60-Day and 30-Day
Federal Register Notices.



Acting as designee on behalf of the Chief Information Officer for submitting
information collection requests to OMB.

2.4

Associate Directors (ADs)

Responsibilities of Associate Directors include:


Ensuring that their respective programs comply with the Paperwork Reduction
Act of 1995, as amended, and implement the procedures in this guide.



Ensuring that their programs have no delinquent information collections.



Designating a Division PRA Coordinator.

2.5

Division PRA Coordinators

Responsibilities of Division PRA Coordinators include:


Ensuring that all information collections are identified and reported to the OPM
PRA Clearance Officer for their respective divisions and programs.



Ensuring that all collection instruments, paper and electronic, are properly
formatted according to OPM standards and OMB requirements.



Ensuring that all supporting documentation that constitutes an information
collection request (ICR) submission package to OMB is complete.



Creating the 60-Day and 30-Day Federal Register Notice packages in OPM’s
Document Management System (DMS) for internal approval and publishing in
the Federal Register.



Responding to questions from the OPM PRA Clearance Officer and the Office of
the General Counsel regarding 60-Day and 30-Day Federal Register Notices in
coordination with the program office that owns the collection of information.



Entering the complete ICR submission package into the Regulatory Information
Service Center (RISC) and Office of Information and Regulatory Affairs (OIRA)
Consolidated Information System (ROCIS) for approval by the OPM PRA
Clearance Officer and submission to OMB for approval.

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

Responding to questions from the OMB Desk Officer for OPM during the 30-day
comment process and OMB approval process regarding ICRs submitted through
ROCIS, in coordination with the program office that owns the collection of
information.



Responding to questions from the public when the approved 60-Day Federal
Register Notice is published.

2.6

General Counsel (GC)

Responsibilities of the General Counsel (GC) include reviewing and approving Federal
Register notices before submission to the Federal Register for publishing.
2.7

Facilities, Security and Contracting (FSC) /Publications Management

Publications Management is responsible for publishing approved 60-Day and 30-Day
Notices to the Federal Register and notifying the OPM PRA Clearance Officer and
Division PRA Coordinator when the notice is published.
3.

INFORMATION COLLECTION POLICIES AND PROCEDURES

3.1

What Is a “Collection of Information”?

At OPM, the terms “information collection” and “collection of information” mean the
same and are used interchangeably.
Per 5 CFR 1320.3(c), a “collection of information” is a technical term that means:
“[T]he obtaining, causing to be obtained, soliciting, or requiring the disclosure to an
agency, third parties or the public of information by or for an agency by means of
identical questions posed to, or identical reporting, recordkeeping, or disclosure
requirements imposed on, ten or more persons, whether such collection of information is
mandatory, voluntary, or required to obtain or retain a benefit.
‘Collection of information’ includes any requirement or request for persons to obtain,
maintain, retain, report, or publicly disclose information. As used in this Part, ‘collection
of information’ refers to the act of collecting or disclosing information, to the information
to be collected or disclosed, to a plan and/or an instrument calling for the collection or
disclosure of information, or any of these, as appropriate.”
An information collection may consist of one or many collection mechanisms (called
“instruments”) in any form or format, including:




Report forms
Application forms
Schedules
4

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












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
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Questionnaires
Surveys
Reporting or recordkeeping requirements
Contracts
Agreements
Policy statements
Plans
Rules or regulations
Planning requirements
Circulars
Directives
Instructions
Bulletins
Requests for proposal or other procurement requirements
Interview guides
Oral communications
Posting, notification, labeling, or similar disclosure requirements
Telegraphic or telephonic requests
Automated, electronic, mechanical, or other technological collection techniques
Standard questionnaires used to monitor compliance with agency requirements
Any other techniques or technological methods used to monitor compliance with
agency requirements.2

3.1.1 Surveys
Surveys are considered to be information collections. Surveys may consist of many
different collection instruments; for example, Web surveys, Web exit surveys, online
surveys, focus groups, and benefits surveys. However, all surveys must meet OMB
Standards and Guidelines.3
3.2

What Information Collections Require OMB Clearance?

OMB must clear an information collection if the agency conducts or sponsors the
collection of information from 10 or more members of the public, regardless of whether
the collection is mandatory, voluntary, or required to obtain or retain a benefit, when the
information is obtained by means of identical questions or identical reporting,
recordkeeping, or disclosure requirements.

See 5 CFR 1320.3(c)(1).
See Office of Management and Budget Standards and Guidelines for Statistical Surveys (September
2006) and Questions and Answers When Designing Surveys For Information Collections, Office of
Information and Regulatory Affairs, Office of Management and Budget (January 2006).

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However, when the information is required to be submitted in response to a rule that is
applicable to the general public rather than any specific entities, OMB clearance is
required regardless of the anticipated number of respondents.
Generally, any information that the public is asked to provide should be presumed to
require OMB clearance unless OMB makes a determination to the contrary.
Under the PRA, “the public” includes individuals, partnerships, corporations,
universities, nonprofit organizations, State, local, and tribal governments and agencies,
and other associations and organizations, whether foreign or domestic. Federal agencies
are not included in the definition of the public. OMB clearance is not required to collect
information from other Federal agencies unless the information will be used for general
statistical purposes. Under the PRA, OMB is responsible for identifying and managing
the collection and use of statistical data throughout the Federal Government.
3.3

What Is Not Considered To Be “Information” Under the PRA?

OMB implementing guidance4 excludes from the definition of “information” disclosures
that require people to provide only facts that “entail no burden other than that necessary
to identify the respondent, the date, the respondent’s address, and the nature of the
instrument.” This includes:











Affidavits, oaths, affirmations, certifications, receipts, changes of address, and
consents or acknowledgements.
Samples of products.
Facts or opinions obtained through direct observation by an employee or agent of
the sponsoring agency.
Facts or opinions submitted in response to general solicitations of comments from
the general public.
Information from individuals under treatment or clinical examination in
connection with research to prevent a clinical disorder.
Facts or opinions requested from a single person.
Examinations designed to test the aptitude, abilities, or knowledge of the person
tested for a collection.
Facts or opinions solicited in connection with public hearings or meetings.
Information solicited through nonstandardized follow-up questions designed to
clarify responses to approved collections of information.
Similar items as designated by OMB.

Additionally, the PRA exempts from its provisions the collection of information during
the conduct of a Federal criminal investigation or prosecution; during the disposition of

See 5 CFR 1320.3(h)).

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other litigation or investigative activities; and during the conduct of intelligence activities
and cryptologic activities that are communications security activities.5
3.4

Overview of the PRA Process at OPM

PRA approval at OPM involves two processes.
1.

The first process is initiated by the PRA Coordinator in the program office
(Division PRA Coordinator) that is sponsoring the information collection.
The PRA Coordinator obtains internal approval through the OPM Document
Management System (DMS) to publish the required 60-Day and 30-Day
Federal Register Notices informing the public of the proposed collection of
information. The procedures for creating DMS packages for 60-Day and
30-Day Notices are described below.
After both notices have been approved through DMS and published in the
Federal Register, the PRA Coordinator initiates the second process.

The second process involves creating the information collection request (ICR)
submission package for OMB approval in the external Regulatory Information
Service Center (RISC) and Office of Information and Regulatory Affairs
(OIRA) Consolidated Information System (ROCIS). The procedures for
creating the ICR submission package in ROCIS are described below.
After the ICR has been entered in ROCIS, the OPM PRA Clearance Officer
reviews and approves it. The Clearance Officer then submits the package to
OMB for final approval.

3.5

Information Collection Request (ICR) Approval Process Timeline

The ICR approval process can vary depending on the complexities of the collection.
Below is a timeline estimate (in business days) for an ICR to undergo OPM approval and
OMB approval. Based on this estimation of approval time, we recommend that Division
PRA Coordinators begin renewing their expiring collections and submitting any new or
anticipated information collections at least 10 months out to allow for internal program
review and approval before entering the package into DMS.
The ICR approval process timeline in business days is outlined below:
1. Approval of 60-Day Notice via DMS. (60 days)
2. Publication of 60-Day Notice in the Federal Register. (4 days)
3. Public comment period for 60-Day Federal Register Notice. (60 days)
5

See 44 U.S.C. 3518.

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4. Approval of 30-Day Federal Register Notice via DMS. (60 days)
5. Publication of 30-Day Notice in the Federal Register. (4 days)
6. Creation of ICR submission package in ROCIS (after 30-Day Federal Register
Notice is published). (10 days)
7. Review and submission of ICR package to OMB. (10 days, although this varies
depending on the completeness of the ICR submission package)
8. OMB review and OPM passback period. The total OMB review period is 60 days,
which includes the 30-day public comment period and OMB’s formal 30-day
review period. OMB’s formal 30-day review period does not begin until the 30day public comment period has lapsed. During the 60-day OMB review period,
discussions or negotiations concerning the ICR may occur between the OPM PRA
Clearance Officer, the Division PRA Coordinator, the sponsoring program office,
and OMB. Comments received by OMB from the public during the 30-day
comment period may also be discussed at this time. (60 days)
9. OMB action. At the conclusion of the 60-day OMB review, OMB issues a Notice
of Action (NOA) through ROCIS. The OMB NOA contains one of three
responses: Approval, Disapproval with a process for appeal, or Withdrawal.
Additionally, terms of clearance may be attached to the ICR.
TOTAL TIME REQUIRED = 208 days maximum from beginning to end.
3.6

Information Collection Request (ICR) Requirements

Every new ICR submitted to OMB for PRA approval requires an OMB Form 83-I,
Paperwork Reduction Act Submission. See appendix H for complete instructions on how
to fill out an OMB 83-I. A fillable 83-I is available for download at
http://www.whitehouse.gov/omb/inforeg/83i-fill.pdf
Along with the 83-I, a number of documents need to be submitted to OMB for PRA
approval. The documents are described below:
1. Proposed information collection instruments with the appropriate Public Burden
Statement, and any additional forms, documents, or pamphlets issued with the
information collection. If this is an electronic application, you must provide
screenshots of the entire online form.
2. Published 60-Day Federal Register Notice.
3. Published 30-Day Federal Register Notice.
4. Supporting Statement Part A – Justification.
5. Supporting Statement Part B (if the collection is a statistical survey).

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6. All applicable Code of Federal Regulations (CFR), U.S. Code (U.S.C.), Executive
Orders (EO), and Public Laws (Pub. L.) that establish the need for the collection
of information and the legal authority for OPM to collect it.
If the ICR involves the collection of personally identifiable information (PII),6 a privacy
impact assessment (PIA) may need to be included in the ICR submission package. Please
contact your designated security officer (DSO) to obtain a copy of the most current PIA
that covers the information collection. Even if no PIA was completed for a particular
collection in the past, if the form implicates PII, then OMB may not approve a renewal or
amendment to the collection form unless a PIA has been completed. Therefore, a PIA
must be created and approved BEFORE submitting the ICR for PRA approval. See
OPM’s Privacy Impact Assessment (PIA) Guide at
http://theo.opm.gov/policies/ispp/PIAGuide.pdf.
If the ICR involves the collection of PII AND the IT system associated with the
information collection uses an element of PII, such as an ID number, social security
number, date of birth, or other element, to retrieve the PII being collected, a system of
records notice (SORN) must be published in the Federal Register BEFORE submitting
the ICR package for PRA approval. See OPM’s System of Records Notice (SORN)
Guide at http://www.opm.gov/privacy/SORNGuide.pdf.
3.7

Collection Instrument Requirements

OMB will not approve collection instruments for PRA unless they contain the following:
1. Public Burden Statement with:
a. Burden estimate
b. Program office name
c. Agency name
2. OMB control number
3. Expiration date
4. Form number
See appendix J for a sample approved OPM Public Burden Statement.
3.8

Federal Register Notice Requirements

A 60-Day and 30-Day Notice for public comment must be published in the Federal
Register for every ICR. Emergency notices are posted only when OPM is requesting an
emergency ICR clearance from OMB and must meet certain legal criteria before they can
be granted. Emergency approvals are thus granted only rarely, and such requests are
discouraged by OMB.

Personally identifiable information (PII) is information that can be used to discern or trace a person’s identity; and
alone, or combined with other information, can be used to compromise the integrity of records relating to a person by
permitting unauthorized access to or unauthorized disclosure of these records.

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3.8.1 60-Day Federal Register Notice
The 60-Day Federal Register Notice is posted to alert the public that OPM plans to
conduct an information collection and submit it to OMB for PRA approval. This notice
includes:

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



A description of the information collection.
A description of the intended audience.
An estimate of how many respondents are expected to participate.
An estimate of the time it will take to complete the information collection.
An estimate of the burden hours on the public.

See the sample 60-Day Federal Register Notice in appendix D for the correct language
and format.
When the notice is published, the public has 60 calendar days to comment on it.
NOTE: Public comments on the 60-Day Notice are sent only to the OPM program office
conducting the information collection. The program office is responsible for responding
to all comments received. The comments must also be sent to OMB as part of the ICR
submission package via ROCIS. OPM offices can only solicit comments via email or
written letter. Phone calls received from the public cannot be recorded accurately;
therefore, the Federal Register notice only lists the contact email and address of the
sponsoring program office.
3.8.2

30-Day Federal Register Notice

The 30-Day Federal Register Notice is posted to alert the public that OPM has submitted
an information collection to OMB for PRA approval. This notice should be identical to
the 60-Day Notice unless there were changes to the collection due to:

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


Comments received during the 60-day comment period.
Program adjustments.
Changing respondent numbers.
Internal OPM review and approval.

The 30-Day Notice also includes the date, volume number, and page number of the
published 60-Day Federal Register Notice. In addition, it must indicate whether any
comments were received during the 60-day period.
When the 30-Day Notice is published, the public has 30 calendar days to comment on it.
Unlike the 60-Day Notice, comments are directed to the OMB desk officer for OPM and
not the OPM program office.

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See the sample 30-Day Federal Register Notice in appendix E for the correct language
and format.
NOTE: The ICR is created in ROCIS when the 30-Day Notice is published. Contact the
OPM PRA Clearance Officer to obtain a ROCIS account and training and to coordinate
the uploading of appropriate documents.
3.8.3 Request for Emergency Clearance of an Information Collection and
Emergency Federal Register Notice
An agency may request emergency clearance only when it needs to begin collecting the
information more quickly than the time a full clearance will require. In every case, the
agency must show that7:
(1) The collection of information must be needed prior to the expiration of the normal
time periods; and
(2) The collection of information is essential to the mission of the agency.
In addition to those two criteria, the agency must, in every case, demonstrate that one of
the following four circumstances is present:
(1) Public harm is likely if normal procedures are followed; or
(2) An unanticipated event has occurred; or
(3) The use of normal procedures is likely to prevent or disrupt the collection; or
(4) The use of normal procedures is likely to cause a statutory or court ordered deadline
to be missed.

Before OMB will take action, the agency must publish an Emergency Federal Register
Notice with a shortened timeframe for public comment and with reduced time for OMB
to take action. In addition, the OPM Chief Information Officer must send a
memorandum to the OPM Desk Officer at OMB explaining the reasons for the
emergency clearance request. OMB may grant emergency clearance for up to 6 months
or 180 days. Emergency clearances, if granted, must be followed by re-initiating the
normal OMB clearance process, i.e., by publishing a 60-Day Federal Register notice and,
subsequently preparing a 30-Day Federal Register Notice and re-requesting clearance by
OMB if the information collection is intended to be used beyond the emergency approval
period. Any comments received during the Emergency Federal Register Notice comment
period must be addressed in the subsequent review process.
7

5 C.F.R. § 1320.13(a)(1).

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See the sample Emergency Federal Register Notice in appendix F for the correct
language and format.
3.9

Supporting Statement Requirements

While the 60-Day Notice is clearing DMS, the Division PRA Coordinator should develop
the Supporting Statement. It includes narrative information explaining the purpose,
scope, and benefits of the collection. The Supporting Statement is divided into two parts:
Part A (Justification) and Part B (Statistical Methodology). Part A is mandatory for all
ICRs, and Part B is required for ICRs that involve statistical methods.
See the instructions on how to create a Supporting Statement in appendix I.
3.10

OPM DMS Procedures

All requests for PRA clearance of information collections must be submitted through
OPM’s Document Management System (DMS) for internal OPM review and approval
before they are submitted to the OPM PRA Clearance Officer for submission to OMB.
Internal OPM approval must be obtained as early as possible because this internal process
can take an indeterminate amount of time. OMB is not concerned with OPM internal
review processes, so failure to clear DMS can never be used as an excuse for an expiring
information collection.
This section explains how to create the OPM DMS internal approval routing list for a 60Day Federal Register Notice, a 30-Day Federal Register Notice, and an Emergency
Federal Register Notice, including the documents required for internal clearance of each
type of notice. When submitting the DMS request, please be sure that all forms and
information collection instruments, revised forms and information collections, other
attachments, and citations are in electronic format and uploaded into DMS.
3.10.1 How to Enter a PRA Clearance Request into DMS
Follow the 16 steps below to enter your PRA clearance request into DMS:
1. Log in to DMS.
2. Select the Priority Correspondence Folder.
3. The Intake screen will open. In the Subject box, type the OMB clearance number
(3206-####) and the title of the form or information collection.
4. In the Document Date box, select the default date that the request is entered into
DMS.

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5. In the Responsible Office box, select the submitting office.
6. In the Date Received box, select the default date.
7. In the Category box, select one of the following as appropriate:
 60-Day PRA Information Collection
 30-Day PRA Information Collection
 Emergency PRA Information Collection
NOTE: The Emergency PRA Information Collection option can only be used
when it has been preapproved by the OPM PRA Clearance Officer and
OMB. These are rarely granted, and OMB frowns upon unjustified or
overly frequent requests.
8. In the Date Due to OD box, select the date the Office of the Director must
receive the package to take action. This date must be before the Final Due Date.
9. In the Final Due Date box, select the date by which the Federal Register notice
must be printed. NOTE: For 30-Day and Emergency Notices, this date must be
before the package can be routed to OMB through ROCIS.
10. In the Recurrence box, select No Recurrence.
11. In the External Obligation box:
 For 60-Day PRA Information Collection – select None.
 For 30-Day PRA Information Collection – select OMB.
 For Emergency PRA Information Collection – select OMB.
12. In the Responsible Office Contact box, select as appropriate.
13. In the Authority box, select as appropriate depending on the information
collection source.
14. In the Handling box, select as appropriate.
15. In the Type box, select as appropriate.
16. In the POC boxes, provide the information indicated.
DMS Routing List
For the DMS routing list, include the following in this order:




Originator and any required program or division approvals.
Associate Director or Division head – Approver.
Chief Information Officer – Approver.
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






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General Counsel – Approver
Facilities, Security and Contracting/Publications Management– Reviewer.
Office of the Director – Approver.
Facilities, Security and Contracting/Publications Management– Reviewer.
Chief Information Officer – Reviewer.
Originator or whoever needs to receive the approved package in the
program office.

3.10.2 DMS 60-Day Federal Register Notice Requirements
The 60-Day Notice should start through the DMS approval process at least a full 13
months before the expiration date of the ICR.
Include the following items with the 60-Day Notice:
1. Draft 60-Day Federal Register Notice.
2. Any legal citation or document that authorizes you to collect the information
(CFR, U.S. Code, Executive Order, etc.).
3. A copy of the form or information collection and any materials that are
issued with it. This may include an additional form, separate instructions, a
pamphlet, or an explanatory sheet. If you have revised your form or information
collection since your last OMB clearance, provide a copy of the old and new
editions highlighting the changes.
3.10.3 DMS 30-Day Federal Register Notice Requirements
The 30-Day Notice should be initiated in DMS as soon as the 60-day comment
period ends.
Include the following items with the 30-Day Notice:
1. Draft 30-Day Federal Register Notice.
2. A copy of the form or information collection and any materials that are
issued with it. This may include an additional form, separate instructions, a
pamphlet, or an explanatory sheet. If you have revised your form or information
collection since the 60-Day Federal Register Notice approval, provide a copy of
the old and new editions highlighting the changes.
3.10.4 DMS Emergency Clearance Federal Register Notice Requirements
Include the following items in the DMS approval package for Emergency Federal
Register Notices:
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1. Emergency Federal Register Notice.
2. Proposed information collection instrument and any additional forms, documents,
or pamphlets issued with the information collection.
3. Previous information collection if this is a revision.
4. All citations.
5. Memorandum from the OPM CIO to the OPM Desk Officer at OMB. See the
sample memorandum in appendix G.
After all internal approvals are obtained via DMS, the OPM Director will sign the
Emergency Federal Register Notice and forward it in DMS to Publications Management
Group for publication in the Federal Register. When the Emergency Federal Register
Notice is published, the Division PRA Coordinator will create the ICR in ROCIS and
send it to the OPM PRA Clearance Officer for submission to OMB.
3.11

Submitting Information Collection Requests (ICRs) to OMB

Federal agencies are required to use the Regulatory Information Service Center (RISC)
and Office of Information and Regulatory Affairs (OIRA) Consolidated Information
System (ROCIS) to create and submit their ICRs to OMB for review. ROCIS is an
Internet-based system developed to improve the ability of OMB and individual Federal
agencies to meet their collection of information responsibilities under the PRA. ROCIS
also provides Federal agencies with the ability to:





Track the receipt and status of OIRA’s review of individual ICRs.
View current and historical OIRA decisions and related records on its reviews of
agency collections of information.
Identify, search, segment, aggregate, and analyze burden data.
Use information stored in the ROCIS database to prepare the agency’s annual
information collection budget.

A login ID and training are required to access ROCIS. Contact the OPM PRA Clearance
Officer to schedule training.
3.12

ROCIS Submission Requirements

Once you receive your ROCIS training and login ID from GSA, please download the
ROCIS How To Guide for Agency Users, available on the ROCIS login screen at
http://www.rocis.gov. This will act as a training refresher and assist you with your
submissions.
You will need to have the following items when you submit your ICR package in
ROCIS:
1. Form 83-I, Paperwork Reduction Act Submission.
2. Supporting Statement Part A – Justification.
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3.
4.
5.
6.

Supporting Statement Part B (if the collection constitutes a statistical survey).
Published 60-Day Federal Register Notice.
Published 30-Day Federal Register Notice.
All applicable Code of Federal Regulations (CFR), U.S. Code (U.S.C.),
Executive Orders (EO), and Public Laws (Pub. L.) that legalize the collection
of information.
7. Proposed information collection instruments with appropriate Public Burden
Statement and any additional forms, documents, or pamphlets issued with the
information collection. If this is an electronic application, you must provide
screenshots of the entire online form.
8. Privacy Impact Assessment (if the ICR involves the collection of personally
identifiable information (PII)).
9. System of Records Notice (if the collection is creating a system of records).
10. Summary of all comments received and responses to comments during the
60-day notice period.

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APPENDIX A: ACRONYMS
Code of Federal Regulations
CFR
Chief Information Officer
CIO
Document Management System at OPM
DMS
Federal Register
FR
General Services Administration
GSA
information collection request
ICR
information technology
IT
Office of Information and Regulatory Affairs
OIRA
Office of Management and Budget
OMB
Office of Personnel Management
OPM
personally identifiable information
PII
privacy impact assessment
PIA
Paperwork Reduction Act
PRA
public law
Pub. L.
Regulatory Information Service Center (GSA)
RISC
RISC and OIRA Consolidated Information System
ROCIS
system of records notice
SORN
social security number
SSN
United States Code
U.S.C.

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APPENDIX B: GLOSSARY
information collection: The obtaining, causing to be obtained, soliciting, or requiring the
disclosure to an agency, third parties or the public of information by or for an agency by
means of identical questions posed to, or identical reporting, recordkeeping, or disclosure
requirements imposed on, ten or more persons, whether such collection of information is
mandatory, voluntary, or required to obtain or retain a benefit (5 CFR 1320.3).
personally identifiable information (PII): Information that can be used to discern or
trace a person’s identity; and alone, or combined with other information, can be used to
compromise the integrity of records relating to a person by permitting unauthorized
access to or unauthorized disclosure of these records.

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APPENDIX C: REFERENCES
C.1





C.2

Authorities
Paperwork Reduction Act of 1995, as amended (44 U.S.C. 3501-3520).
Clinger-Cohen Act of 1996, Information Technology Management Reform Act
(Pub. L. 104-106).
5 CFR 1320, Controlling Paperwork Burdens on the Public.
Executive Order 12291, Federal Regulation.
External and Internal Issuances Incorporated by Reference

C.2.1 External References




Office of Management and Budget Standards and Guidelines for Statistical
Surveys.
Questions and Answers When Designing Surveys For Information Collections,
Office of Information and Regulatory Affairs, Office of Management and Budget.
Christopher and Schmitt, Environmental Monitoring and Sampling Primer, 1997

C.2.2 OPM Internal References



Privacy Impact Assessment (PIA) Guide
System of Records Notice (SORN) Guide

C.2.3 Forms


OMB 83-I, Paperwork Reduction Act Submission

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APPENDIX D: SAMPLE 60-DAY FEDERAL REGISTER NOTICE
Publication Date:____________________
6325-38
U.S. OFFICE OF PERSONNEL MANAGEMENT
Submission for Review: Federal Cyber Service: Scholarship For Service (SFS)
Registration Website
AGENCY: U.S. Office of Personnel Management.
ACTION: 60-Day Notice and request for comments.
SUMMARY: The Human Resources Solutions, Office of Personnel Management
(OPM) offers the general public and other federal agencies the opportunity to comment
on an existing information collection request (ICR) 3206-0246, SFS Registration. As
required by the Paperwork Reduction Act of 1995, (Pub. L. 104-13, 44 U.S.C. chapter
35) as amended by the Clinger-Cohen Act (Pub. L. 104-106), OPM is soliciting
comments for this collection. The Office of Management and Budget is particularly
interested in comments that:
1. Evaluate whether the proposed collection of information is necessary for the
proper performance of the functions of the agency, including whether the
information will have practical utility;
2. Evaluate the accuracy of the agency's estimate of the burden of the proposed
collection of information, including the validity of the methodology and
assumptions used;
3. Enhance the quality, utility, and clarity of the information to be collected; and
4. Minimize the burden of the collection of information on those who are to respond,
including through the use of appropriate automated, electronic, mechanical, or
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other technological collection techniques or other forms of information
technology, e.g., permitting electronic submissions of responses.
DATES: Comments are encouraged and will be accepted until [INSERT DATE 60
DAYS AFTER DATE OF PUBLICATION IN THE FEDERAL REGISTER]. This
process is conducted in accordance with 5 CFR 1320.1.
ADDRESS: Interested persons are invited to submit written comments on the proposed
information collection to U.S. Office of Personnel Management, San Antonio Office,
8610 Broadway, Rm. 305, San Antonio, TX 78217, Attention: Kathryn Roberson or sent
via electronic mail to sfs@opm.gov.
FOR FURTHER INFORMATION CONTACT: A copy of this ICR, with applicable
supporting documentation, may be obtained by contacting the San Antonio Services
Branch, Office of Personnel Management, 8610 Broadway, Rm. 305, San Antonio, TX
78217, Attention: Kathryn Roberson or sent via electronic mail to sfs@opm.gov.
SUPPLEMENTARY INFORMATION:
The SFS Program was established by the National Science Foundation in accordance
with the Federal Cyber Service Training and Education Initiative as described in the
President’s National Plan for Information Systems Protection. This program seeks to
increase the number of qualified students entering the fields of information assurance and
computer security in an effort to respond to the threat to the Federal Government’s
information technology infrastructure. The program provides selected 4-year colleges
and universities scholarship grants to attract students to the information assurance field.
Participating students who receive scholarships from this program are required to serve a
10-week internship during their studies and complete a post-graduation employment

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commitment equivalent to the length of the scholarship or one year, whichever is longer.
Approval of the webpage is necessary to facilitate the timely registration, selection and
placement of program-enrolled students in Federal agencies.
ANALYSIS:
Agency: Federal Cyber Service: Scholarship For Service Program, Office of Personnel
Management
Title: Scholarship For Service (SFS) Program Internet Site
OMB Number: 3206-0246
Frequency: Annually
Affected Public: Individuals or Households
Number of Respondents: 630
Estimated Time Per Respondent: 1 hour
Total Burden Hours: 630 hours

U.S. Office of Personnel Management.
____________________________________
John Berry,
Director.
6325-38

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APPENDIX E: SAMPLE 30-DAY FEDERAL REGISTER NOTICE
Publication Date:____________________
6325-38
U.S. OFFICE OF PERSONNEL MANAGEMENT
Submission for Review: OPM Form 1203-FX, Occupational Questionnaire, 32060040
AGENCY: U.S. Office of Personnel Management.
ACTION: 30-Day Notice and request for comments.
SUMMARY: The Automated Services Management Group, Office of Personnel
Management (OPM) offers the general public and other federal agencies the opportunity
to comment on an existing information collection request (ICR) 3206-0040, Occupational
Questionnaire, OPM Form 1203-FX. As required by the Paperwork Reduction Act of
1995, (Pub. L. 104-13, 44 U.S.C. chapter 35) as amended by the Clinger-Cohen Act (Pub.
L. 104-106), OPM is soliciting comments for this collection. The information collection
was previously published in the Federal Register on September 18, 2009 at Volume 74
FR 47981 allowing for a 60-day public comment period. No comments were received for
this information collection. The purpose of this notice is to allow an additional 30 days
for public comments. The Office of Management and Budget is particularly interested in
comments that:
5. Evaluate whether the proposed collection of information is necessary for the
proper performance of the functions of the agency, including whether the
information will have practical utility;
6. Evaluate the accuracy of the agency's estimate of the burden of the proposed
collection of information, including the validity of the methodology and
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assumptions used;
7. Enhance the quality, utility, and clarity of the information to be collected; and
8. Minimize the burden of the collection of information on those who are to respond,
including through the use of appropriate automated, electronic, mechanical, or
other technological collection techniques or other forms of information
technology, e.g., permitting electronic submissions of responses.
DATES: Comments are encouraged and will be accepted until [INSERT DATE 30
DAYS AFTER DATE OF PUBLICATION IN THE FEDERAL REGISTER]. This
process is conducted in accordance with 5 CFR 1320.1.
ADDRESS: Interested persons are invited to submit written comments on the proposed
information collection to the Office of Information and Regulatory Affairs, Office of
Management and Budget, 725 17th Street, NW, Washington, DC 20503, Attention: Desk
Officer for the Office of Personnel Management or sent via electronic mail to
oira_submission@omb.eop.gov or faxed to (202) 395-6974.
FOR FURTHER INFORMATION CONTACT: A copy of this ICR, with applicable
supporting documentation, may be obtained by contacting the Office of Information and
Regulatory Affairs, Office of Management and Budget, 725 17th Street, NW,
Washington, DC 20503, Attention: Desk Officer for the Office of Personnel
Management or sent via electronic mail to oira_submission@omb.eop.gov or faxed to
(202) 395-6974.
SUPPLEMENTARY INFORMATION: The Occupational Questionnaire is an optical
scan form designed to collect applicant information and qualifications in a format suitable
for automated processing and to create applicant records for an automated examining

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system. The 1203 series was commonly referred to as the “Qualifications and
Availability Form C.” OPM has re-titled the series as “Occupational Questionnaire” to
fit a more generic need. OPM uses this form to carry out its responsibility for open
competitive examining for admission to the competitive service in accordance with
section 3304, of title 5, United States Code.
ANALYSIS:
Agency: Automated Systems Management Group, Office of Personnel Management
Title: Occupational Questionnaire, OPM Form 1203-FX
OMB Number: 3260-0040
Frequency: On occasion
Affected Public: Individuals or households
Number of Respondents: 3,484,764
Estimated Time Per Respondent: 45 minutes
Total Burden Hours: 2,613,573

U.S. Office of Personnel Management.
____________________________________
John Berry,
Director.
6325-38

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APPENDIX F: SAMPLE EMERGENCY FEDERAL REGISTER NOTICE
Publication Date:____________________
6325-38
OFFICE OF PERSONNEL MANAGEMENT
Submission for OMB Emergency Review: OPM Form 1203-FX, Occupational
Questionnaire, 3206-0040
AGENCY: Office of Personnel Management.
ACTION: Emergency Clearance Notice and request for comments.
SUMMARY: The Human Resources Solutions, Office of Personnel Management
(OPM) submitted a request to the Office of Management and Budget (OMB) for
emergency clearance and review for OPM Form 1203-FX, Occupational Questionnaire,
3206-0040. As required by the Paperwork Reduction Act of 1995, (Pub. L. 104-13, 44
U.S.C. chapter 35) as amended by the Clinger-Cohen Act (Pub. L. 104-106), OPM is
soliciting comments for this collection. The Office of Management and Budget is
particularly interested in comments that:
1. Evaluate whether the proposed collection of information is necessary for the
proper performance of the functions of the agency, including whether the
information will have practical utility;
2. Evaluate the accuracy of the agency's estimate of the burden of the proposed
collection of information, including the validity of the methodology and
assumptions used;
3. Enhance the quality, utility, and clarity of the information to be collected; and
4. Minimize the burden of the collection of information on those who are to respond,
including through the use of appropriate automated, electronic, mechanical, or
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other technological collection techniques or other forms of information
technology, e.g., permitting electronic submissions of responses.
DATES: Comments on this proposal for emergency review should be received within
[INSERT DATE 10 DAYS AFTER DATE OF PUBLICATION IN THE FEDERAL
REGISTER]. We are requesting OMB to take action within 10 calendar days from the
close of this Federal Register Notice on the request for emergency review. This process
is conducted in accordance with 5 CFR 1320.1.
ADDRESS: Interested persons are invited to submit written comments on the proposed
information collection to the Office of Information and Regulatory Affairs, Office of
Management and Budget, 725 17th Street, NW, Washington, DC 20503, Attention: Desk
Officer for the Office of Personnel Management or sent via electronic mail to
oira_submission@omb.eop.gov or faxed to (202) 395-6974.
SUPPLEMENTARY INFORMATION: The Occupational Questionnaire is an optical
scan form designed to collect applicant information and qualifications in a format suitable
for automated processing and to create applicant records for an automated examining
system. The 1203 series was commonly referred to as the “Qualifications and
Availability Form C.” OPM has re-titled the series as “Occupational Questionnaire” to
fit a more generic need. OPM uses this form to carry out its responsibility for open
competitive examining for admission to the competitive service in accordance with
section 3304, of title 5, United States Code.
Agency: Automated Systems Management Group, Office of Personnel Management
Title: Occupational Questionnaire, OPM Form 1203-FX
OMB Number: 3260-0040

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Frequency: On occasion
Affected Public: Individuals or households
Number of Respondents: 3,484,764
Estimated Time Per Respondent: 45 minutes
Total Burden Hours: 2,613,573

U.S. Office of Personnel Management.
____________________________________
John Berry,
Director.
6325 – 38

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APPENDIX G: SAMPLE OMB MEMORANDUM FOR EMERGENCY
CLEARANCE
MEMORANDUM FOR:
OMB Designee
OPM Desk Officer
Office of Management and Budget
FROM:
OPM Designee
Deputy Associate Director
Chief Information Officer
SUBJECT: Request for Emergency Clearance
This is to request emergency clearance for [briefly describe the information collection
and provide the current or former OMB clearance number if applicable]. [If true,
include the following statement] In addition to the emergency clearance, we will also
complete the normal OMB review process and post the 60-Day and 30 Day Federal
Register Notices following the Emergency Federal Register Notice.
[Describe in detail why OPM is requesting emergency clearance, and include the
following information:
 Why emergency clearance is essential to the agency mission.
 Why the agency cannot reasonably comply with normal clearance procedures, and
show how:
a. Public harm is likely to result if normal clearance procedures are followed,
b. An unanticipated event has occurred, or
c. Use of normal clearance procedures is reasonably likely to prevent or
disrupt the collection of information or is likely to cause a statutory or
court-ordered deadline to be missed.
 The time period within which OMB should approve or disapprove the information
collection.
 How OPM has taken all practicable steps to consult with interested agencies and
members of the public to minimize the burden of the information collection.]

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APPENDIX H: INSTRUCTIONS FOR COMPLETING OMB FORM 83-I
1. Agency/Subagency originating request – Enter OPM and the program office name.
2. OMB control number – If the information collection has previously been approved
by OMB, enter the control number that was assigned (whether current or expired). For
OPM, it will always start with 3206 and have 4 additional digits. Check b for None for
new collections that have never been assigned a control number.
3. Type of information collection – Check only one block, as follows:
a. Check New Collection when the collection has not previously been used
by OPM.
b. Check Revision when the collection is currently approved by OMB and
you wish to make a change in the questions asked, the manner of the
collection, the burden estimate, or the way in which the information will
be used.
c. Check Extension when the collection currently has OMB approval, you
wish to extend that approval past the current OMB expiration date
(generally, renew for another 3 years), and no change is proposed for the
collection.
d. Check Reinstatement, without change when you are submitting a
collection that previously had OMB approval, the approval expired, and
no major change has been made in the previously approved collection.
e. Check Reinstatement, with change when the collection is like d above,
but has been changed since the prior approval.
f. Check Existing collection in use without an OMB control number if
the collection has been in use without ever having received OMB
approval. If you check this block, your request must be accompanied by a
memo explaining why this violation of the Paperwork Reduction Act took
place.
4. Type of review requested – Block a, Regular Submission, should always be checked
unless instructed otherwise by the OPM PRA Clearance Officer. If you have a situation
that requires OMB approval in less than 60 days to avoid some damaging effect on the
public or the environment, contact the OPM PRA Clearance Officer or your Division
PRA Coordinator to discuss the situation. Not meeting a deadline because of lack of
foresight is not regarded as an emergency by OPM or OMB.
5. Small Entities – Indicate whether this information collection will have a significant
impact on a substantial number of small entities. A small entity may be (1) a small
business that is independently owned and operated and that is not dominant in its field of
operations; (2) a small organization that is any not-for-profit enterprise independently
owned and operated and is not dominant in its field; or (3) a small government

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jurisdiction that is the government of a city, county, town, township, school district, or
special district with a population of less that 50,000.
6. Requested expiration date – Check block a for 3-year approval unless you know that
the collection's life will be less than 3 years. In the latter case, check block b and enter a
date. DO NOT request an expiration date beyond 3 years, as OMB is prohibited by law
from giving such an approval. If the action is a revision to a currently approved
collection, enter the existing expiration date for the collection.
7. Title – Provide a title for the information collection. If the submission is a revision to
a currently approved collection, use the title for the overall collection rather than
providing the title of the change to take place. Usually you should not use the title of any
associated rulemaking, as it will not specifically identify the information collection itself.
8. Agency form numbers – Enter the numbers of any OPM numbered forms to be used
in the collection. When multiple forms will be used, separate the numbers with commas.
If the only number on the form is the OMB control number, do not list it here but put NA.
9. Keywords – Enter OPM, the name of the collection, and the program office.
10. Abstract – Provide a brief statement, in 5-10 lines of text, describing the need for the
information and how it will be used.
11. Affected public – Mark all the categories that apply. Mark the primary respondent
group with a P and the secondary respondent group with an X.
12. Obligation to respond –
a. Check Voluntary when the response is entirely discretionary and has no
direct effect on any benefit or privilege for the respondent.
b. Check Required to obtain or retain a benefit when the response is
elective but is required to obtain or retain a benefit (e.g., a loan).
c. Check Mandatory when the respondent must respond by statute or
regulation.
13. Annual recordkeeping and reporting burden – Enter the information described
below. If you are requesting approval for 3 years, and the number of respondents,
responses, or burden hours will vary significantly during that period, provide an annual
average over the period rather than the maximum year's figures. If the submission is a
revision to an existing collection, the numbers should reflect the new totals for the overall
collection, and not just the changes being made. That is, if you are adding six
respondents, 100 responses, and 25 burden hours per year, these are not your new annual
totals; the new totals reflect the current numbers plus the added numbers (e.g., current
hours of 500 plus added 25 hours equals 525).

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If you do not have accurate data on the totals, contact the OPM PRA Clearance
Officer or check the current totals for this collection in ROCIS:
Some reasons why the totals may have changed since the last renewal are a revision
submitted through this same process, or a change worksheet that may have merged
another collection into this one. If you are not a new sponsor for this collection, you will
have been the one doing the revising or merging, but it still never hurts to check your
totals!
a. Enter the total number of respondents, annualized over the 3-year approval
period. That is, if each respondent responds at least once per year, do not
divide by 3 – your annual respondent total is the same as your overall
total. If each respondent responds less often than annually in the 3-year
period, divide the total by 3. Do not double-count respondents: if 15
people file 3 reports per year, you have 15 respondents, not 45.
b. Enter the total number of responses provided annually. Provide the
percentage of responses that will be submitted or collected using
electronic media (other than telephones and facsimile submissions). Do
not include the entering of submitted information into a computer after
receipt in OPM.
c. Enter the total annual reporting and recordkeeping burden in hours.
d. Enter the total annual burden-hours currently approved by OMB. Enter 0
for a new collection or a collection for which OMB approval has expired.
e. Enter the difference by subtracting line d from line c. Record a negative
number in parentheses.
f. Based on the reason for the difference (program change or adjustment),
enter the amount of the difference shown in line e, in lines f1 and f2.
f1. Program change – This is the result of deliberate Federal Government action. All
new collections and any subsequent revisions or changes resulting in cost changes are
recorded as program changes.
f2. Adjustment – This is a change that is not the result of a deliberate Federal
Government action. Changes resulting from new estimations or actions not controllable
by the Federal Government are recorded as adjustments.
If appropriate, both program changes and adjustments can be used to explain applicable
components of a burden-hour change. Examples: Of a total difference (increase) of 400,
300 could be due to program change and 100, to adjustment, OR you could have a
decrease of 100 due to program change and an increase of 500 due to adjustment, which
would still be a net increase of 400.
14. Annual reporting and recordkeeping cost burden – The costs identified in this
item are those identified in item 13 of the Supporting Statement ONLY, that is,
recordkeeping or reporting costs, NOT labor costs (labor costs are addressed ONLY in
the Supporting Statement item 12, and do not appear on the 83-I).

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a. Enter the total dollar amount of annualized costs for all respondents of any
associated capital or start-up costs (e.g., the cost of buying and setting up a
computer needed to make the reports, divided by 3 years).
b. Enter the recurring annual dollar amount of costs for all respondents
associated with operating or maintaining systems or purchasing services.
Include any money the respondent spends to comply with the information
request or requirement (e.g., for attorney fees). Operations and
maintenance costs include the costs of mailing, faxing, or calling in
information, making paper copies, notary costs, and electronic
transmissions. Regular maintenance of any equipment whose initial costs
fall under “capital and start-up” would also belong here.
c. Enter the total of 14a + 14b as requested annual reporting and
recordkeeping cost burden.
d. Enter the total cost burden currently approved by OMB for this collection
of information. Enter zero (0) if this is a new submission.
e. Enter the difference by subtracting line d from line c. Record a negative
number within parentheses.
f. If appropriate, both program changes and adjustments can be used to
explain applicable components of a burden-hour change. Based on the
reason for the difference (program change or adjustment), enter the
amount of the difference shown in line e, in lines f1 and f2. See #13 above
for definitions and examples.
15. Purpose of information collection – Check all that apply, using a P for the primary
purpose and an X for all others.
16. Frequency of recordkeeping or reporting –
a. Check Recordkeeping if the collection of information explicitly requires
a person to maintain records that will not subsequently be submitted to the
Federal Government.
b. Check Third party disclosure if a collection of information requires a
person to obtain or compile information for the purpose of disclosure to
members of the public or the public at large, through posting, notification,
labeling, or similar requirements.
c. Check Reporting for information collections that involve reporting to the
Federal Government and check the frequency of reporting that is requested
or required of a respondent. If the reporting is triggered by an event, check
On occasion.
17. Statistical methods – Many research collections and scientific program evaluations
employ statistical methods, while applications and audits do not.
Check Yes if you are:

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a. Collecting data using any survey methods.
Note: OMB is now including census (collection from the entire respondent
population) under “sampling”, and since sampling is a statistical method,
for any information collection referred to as a “survey” you must check
Yes (see below).
b. Doing any kind of estimation, imputation, or weighting.
c. Pretesting or field testing for a survey, including cognitive interviews or
focus groups from a total of 10 or more people.
If you check Yes, you must also answer Part B in the Supporting Statement (see the
instructions in appendix I, part B).
18. Agency contact – Provide the name and telephone number of someone able to
answer questions regarding the content of the submission.
19. Certification – DO NOT SIGN THIS BLOCK! No entry is needed. However, you do
need to review the certification standards on this page, and if the collection fails to meet
one or more of those standards, item 18 of the Supporting Statement must explain the
reason for that failure.
Agency Certification – OPM requires that the OMB Form 83-I be signed by an
Associate Director, Deputy Associate Director or program manager.

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APPENDIX I: HOW TO CREATE A SUPPORTING STATEMENT
General Instructions
A Supporting Statement, including the text of the notice to the public required by 5 CFR
1320.5(a)(i)(iv) and its actual or estimated date of publication in the Federal Register,
must accompany each request for approval of a collection of information. The Supporting
Statement must be prepared in the format described below, and must contain the
information specified in part A below. If an item is not applicable, provide a brief
explanation. When the question “Does this ICR contain surveys or censuses or employ
statistical methods” is checked "Yes", part B of the Supporting Statement must also be
completed. OMB reserves the right to require the submission of additional information
with respect to any request for approval.
Specific Instructions
Start with the title of the collection, any associated forms used, and the control number
for this collection.
Title:
Form names and numbers:
OMB Control Number: 3206-xxxx
PART A. JUSTIFICATION
1. Explain the circumstances that make the collection of information necessary.
Include a citation and brief description of any statute or Executive order that requires the
collection, as well as any pending regulations on which revisions are based, if applicable.
Copies of statutes mandating or authorizing a collection must be included with all
submissions. Provide some background information on the program and describe how the
collection supports it. Detail any specific program problems you hope to resolve.
2. Indicate how, by whom, and for what purpose the information is to be used.
Except for a new collection, indicate the actual use the agency has made of the
information received from the current collection.
For all but "New" collection requests, indicate the actual use OPM has made of the
information received. This explanation of the proposed and any past use of the
information is a key one and must be detailed. Do not just make general statements about
the overall use of the information, but address the specific items of information being
collected. You should deal individually with each question or type of question being
asked in your survey or on your form unless the purpose of the question is obvious to

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someone not familiar with your program. One of OMB's key standards under the
Paperwork Reduction Act is whether the information has "practical utility"; you must
demonstrate that you will be using all of the information collected for a practical and
necessary program purpose.
3. Describe whether, and to what extent, the collection of information involves the
use of automated, electronic, mechanical, or other technological collection
techniques or other forms of information technology.
Explain the basis for the decision for adopting this means of collection. Also describe any
consideration you have given or are giving to the use of improved information
technology to reduce the burden on the public. You must address the following:




Is the electronic submission of responses possible?
If a form is involved, is it available on the Internet for public printing?
Will the results of the information collection be made available to the public over
the Internet?

If the answer to any of those questions is “no”, are there plans to do so? If not, why not?
4. Describe efforts to identify duplication. Show specifically why any similar
information already available cannot be used or modified for use for the purposes
described in item 2 above.
Describe your efforts to identify duplication with other collections (under other OMB
control numbers or collections by other agencies, etc.) that may be gathering the same or
similar information. If the same or similar information is available, describe why it
cannot be used or modified for the purposes described in item 2 above.
5. If the collection of information impacts small businesses or other small entities,
describe any methods used to minimize burden.
If the collection will have a significant impact on small entities such as small businesses,
organizations, or government bodies (see the instruction above for item 5 of the OMB 83I), describe the methods used to minimize the burden on them.
6. Describe the consequence to Federal program or policy activities if the collection
is not conducted or is conducted less frequently, as well as any technical or legal
obstacles to reducing the burden.
Address both parts of the question: not conducting the collection AND doing it less
frequently. Generally one or two paragraphs are sufficient.
7. Explain any special circumstances that would cause an information collection to
be conducted in a manner:

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









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Requiring respondents to report information to the agency more often than
quarterly;
Requiring respondents to prepare a written response to a collection of
information in fewer than 30 days after receipt of it;
Requiring respondents to submit more than an original and two copies of any
document;
Requiring respondents to retain records, other than health, medical,
government contract, grant-in-aid, or tax records, for more than 3 years;
In connection with a statistical survey, that is not designed to produce valid
and reliable results that can be generalized to the universe of study;
Requiring the use of a statistical data classification that has not been reviewed
and approved by OMB;
That includes a pledge of confidentiality that is not supported by authority
established in statute or regulation, that is not supported by disclosure and
data security policies that are consistent with the pledge, or that unnecessarily
impedes sharing of data with other agencies for compatible confidential use;
or
Requiring respondents to submit proprietary trade secrets or other confidential
information unless the agency can demonstrate that it has instituted
procedures to protect the information's confidentiality to the extent permitted
by law.

8. If applicable, provide a copy and identify the date and page number of
publication in the Federal Register of the agency's notice, required by 5 CFR
1320.8(d), soliciting comments on the information collection prior to submission to
OMB.
The first sentence should read: “On [indicate month, day, and year], a 60-Day Federal
Register Notice was published at 73 FR 12746 [indicate volume and page number]. No
comments were received.” [If pertinent comments were received, state: “## comments
were received and responded to”.]
If you are submitting the request in association with a Notice of Proposed Rulemaking,
eliminate the sentence about publication of a Federal Register notice and state that a
proposed rule will be published for public comment. Please give the Regulation Identifier
Number (RIN).
9. Explain any decision to provide any payment or gift to respondents, other than
remuneration of contractors or grantees.
Payments or gifts are generally not permissible, so if you are proposing to do so, provide
a justification, including your authority for making such payments or gifts.
10. Describe any assurance of confidentiality provided to respondents and the basis
for the assurance in statute, regulation, or agency policy.

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You must cite a specific authority for promising confidentiality. If there is no applicable
authority, and you do plan to protect the information, please describe the management,
operational, and technical safeguards, but do not state that information will be
confidential.
If the Privacy Act (5 U.S.C. 552a) applies to a collection (see below), it can be used as a
statutory authority for confidentiality. If there is another appropriate statutory authority in
addition to the Privacy Act, it is best to cite that authority. However, if the Privacy Act
applies, compliance with this Act is still necessary (see below).
This Act generally applies if records will be primarily retrieved by personally identifiable
information, e.g., name, social security number (SSN), or date of birth. This Act “governs
the collection, maintenance, and disclosure of information from or about identifiable
individuals (not statistical or aggregate information).” For these purposes, corporations
are not considered to be individuals, but persons acting as or for corporations are still
considered individuals. Also, if a business does not have an employer identification
number (EIN) and thus must supply an SSN, the SSN requires protection under the
Privacy Act.
If an information collection falls under this Act, a Privacy Act system of records notice
must be published in the Federal Register, which describes how and where the
information is stored, and how it is secured. If a system of records already exists under
which this collection would fall, you do not need to go through this process.
If you request a respondent’s SSN, this Privacy Act note (Section 7(a)(1)(b)) applies,
“Any Federal, State or local government agency which requests an individual to
disclose his social security account number shall inform that individual whether that
disclosure is mandatory or voluntary, by what statutory or other authority such
number is solicited, and what uses will be made of it.”
The applicable statement must be included along with the Paperwork Reduction Act
statement on all forms that request an SSN.
11. Provide additional justification for any questions of a sensitive nature, such as
sexual behavior and attitudes, religious beliefs, and other matters that are
commonly considered private.
This justification should include the reasons why the agency considers the questions
necessary, the specific uses to be made of the information, the explanation to be given to
people from whom the information is requested, and any steps to be taken to obtain their
consent. Finally, OMB has standards8 for asking questions about race or ethnicity. If
you ask such questions, you must comply with those standards.
12. Provide estimates of the hour burden of the collection of information. The
statement should:
8

See OMB Directive 15, Race and Ethnic Standards for Federal Statistics and Administrative Reporting.

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Form
Name

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

Indicate the number of respondents, frequency of response, annual hour
burden, and an explanation of how the burden was estimated. Unless directed
to do so, agencies should not conduct special surveys to obtain information on
which to base hour burden estimates. Consultation with a sample of potential
respondents (fewer than 10) is desirable. If the hour burden on respondents is
expected to vary widely because of differences in activity, size, or complexity,
show the range of estimated hour burden and explain the reasons for the
variance. Generally, estimates should not include burden hours for customary
and usual business practices. Note: If this request for approval covers more
than one form, provide separate hour burden estimates for each form and
aggregate the hour burdens.



Provide estimates of annualized cost to respondents for the hour burdens for
collections of information, identifying and using appropriate wage rate
categories. The cost of contracting out or paying outside parties for
information collection activities should not be included here. Instead, this cost
should be included under item 13.
Form
Number

No. of
Respondents

No. of
Responses
per
Respondent

Average.
Burden per
Response (in
hours)

Total

Total
Annual
Burden
(in hours)

Average
Hourly
Wage
Rate

$
$

Total
Annual
Respondent
Cost

13. Provide an estimate for the total annual cost burden to respondents or recordkeepers resulting from the collection of information. Do NOT include the labor cost
(wage equivalent) of the burden-hours described in item 12 above. The information
required here corresponds to that in item 14 on the 83-I (cost to the public).
The cost estimate should be split into two components:
1. A total capital and start-up cost component (annualized over its expected useful
life).
2. A total operation and maintenance and purchase of services component.
The estimates should take into account costs associated with generating, maintaining, and
disclosing or providing the information. Include descriptions of methods used to estimate
major cost factors, including system and technology acquisition, expected useful life of
capital equipment, the discount rates, and the time period over which costs will be
incurred. Capital and start-up costs include, among other items, preparations for
collecting information such as purchasing computers and software; monitoring, sampling,
drilling and testing equipment; and record storage facilities.

$
$

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If cost estimates are expected to vary widely, agencies should present ranges of cost
burdens and explain the reasons for the variance. The cost of purchasing or contracting
out information collections services should be a part of this cost burden estimate. In
developing cost burden estimates, agencies may consult with a sample of respondents
(fewer than 10), use the 60-day pre-OMB submission public comment process, and use
existing economic or regulatory impact analysis associated with the rulemaking
containing the information collection, as appropriate.
Generally, estimates should not include purchases of equipment or services, or portions
of them, made (1) prior to October 1, 1995, (2) to achieve regulatory compliance with
requirements not associated with the information collection, (3) for reasons other than to
provide information or keep records for the Government, or (4) as part of customary and
usual business or private practices.
14. Provide estimates of annualized costs to the Federal Government.
Include here a description of the method used to estimate costs to the Federal
Government, which should show the quantification of hours, operational expenses (such
as equipment, overhead, printing, and staff support), and any other expense that would
not have been incurred without this collection of information. If there will be no costs
beyond the normal labor costs for staff, state that here.
15. Explain the reasons for any program changes or adjustments reported on the
burden worksheet.
Program changes are new collections or changes in requirements. Adjustments are reestimates of the number of respondents, responses, or the response times for existing
requirements. Please be more specific than, for example, “Changes were due to the
requirement that _____". List at least net changes and the specific reasons for them; for
example, “Increased reporting or recordkeeping costs are due to the capital costs of …”.
If there are no changes, simply state, “There are no changes” with no further explanation.
If this is a new program, obviously there can be no changes from a previous version,
simply state “This is a new program”.
16. For collections of information whose results will be published, outline plans for
tabulation and publication. Address any complex analytical techniques that will be
used. Provide the time schedule for the entire project, including beginning and
ending dates of the collection of information, completion of report, publication
dates, and other actions.
Address any complex analytical techniques that will be used. Provide a time schedule for
the collection, publication, and other actions. Also, will the results of the collection be
made available on your organization’s Web site? If not, why not?

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17. If you are seeking approval to not display the expiration date for OMB approval
of the information collection, explain the reasons that display would be
inappropriate.
If your collection consists of a paper form, you may request exemption from printing the
expiration date on the forms based on the high cost of reprinting. However if you have
an electronic application, for example, online data entry screens, you may not claim this
exemption.
18. Explain each exception to the topics of the certification statement identified in
Certification for Paperwork Reduction Act Submissions.
Self-explanatory. There are virtually never exceptions.
PART B. COLLECTIONS OF INFORMATION EMPLOYING STATISTICAL
METHODS
If your collection does not employ statistical methods, state that and delete the following
five questions from the format – UNLESS your proposed information collection is a
survey. OMB recently clarified that Part B must be completed for all survey requests,
whether or not statistical analysis will be applied. In addition to statistical analysis, Part B
addresses the description of the target group of respondents, the sampling plan, and plans
to maximize response rates and address nonresponse. When item 17 of the OMB 83-I is
checked "Yes", the following documentation must be provided to the extent that it applies
to the methods proposed.
1. Describe (including a numerical estimate) the potential respondent universe and
any sampling or other respondent selection methods to be used. Data on the number
of entities (e.g., establishments, State and local government units, households, or
persons) in the universe covered by the collection and in the corresponding sample
are to be provided in tabular form for the universe as a whole and for each of the
strata in the proposed sample. Indicate expected response rates for the collection as
a whole. If the collection had been conducted previously, include the actual response
rate achieved during the last collection.
Response rate means -- Of those in your respondent sample, from what percentage do
you expect to get the required information (if this is not a mandatory collection). The
nonrespondents would include those you could not contact, as well as those you
contacted but who refused to give the information.
2. Describe the procedures for the collection of information, including:
 Statistical methodology for stratification and sample selection.
 Estimation procedure.
 Degree of accuracy needed for the purpose described in the justification.
 Unusual problems requiring specialized sampling procedures,

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

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Any use of periodic (less frequent than annual) data collection cycles to
reduce burden.

If you are selecting a uniform respondent universe, you may be using a simple random
numbers table to select a sample.
Stratified sampling is often used when the sampling population can be split into
nonoverlapping strata that individually are more homogeneous than the population as a
whole (e.g., gender and age groups). If there are no obvious "dividing lines", grid lines
can be used to divide the population. Random samples are taken from each stratum (or
class) and the results are combined to estimate a population mean. Stratified sampling is
most successful when the variance within each stratum is less than the overall variance of
the population.9
3. Describe methods to maximize response rates and to deal with issues of
nonresponse. The accuracy and reliability of information collected must be shown to
be adequate for intended uses. For collections based on sampling, a special
justification must be provided for any collection that will not yield "reliable" data
that can be generalized to the universe studied.
Any aspect of your plan that makes it easier and more attractive to comply with the
request for information would tend to maximize response rate. This would include:




Such steps as prenotification and various types of followup with those who
did not respond at the first opportunity (give details, e.g., intervals for
followup, types of followup, how many times you will follow up).
Making the questions as simple and brief as possible.
Already having a good working relationship with this group or the group’s
perception that actions based on the information collected would be helpful to
them.

A lower response rate than 75% would definitely require a plan to address nonresponse,
according to OMB’s standards. This means that a large enough number of respondents
didn’t give information so that there is a possibility that their answers as a group might
have differed significantly from those who did respond. Following up with
nonrespondents – resending surveys or sending a shorter version of the survey, trying a
phone interview if possible, etc. – are all effective strategies.
4. Describe any tests of procedures or methods to be undertaken. Testing is
encouraged as an effective means of refining collections of information to minimize
burden and improve utility. Tests must be approved if they call for answers to
identical questions from 10 or more respondents. A proposed test or set of test may
be submitted for approval separately or in combination with the main collection of
information.
9

Christopher and Schmitt, Environmental Monitoring and Sampling Primer, 1997:
http://ewr.cee.vt.edu/environmental/teach/smprimer/design/sample.html#stratified.

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If you are employing testing, please describe it here.
5. Provide the name and telephone number of individuals consulted on statistical
aspects of the design and the name of the agency unit, contractors, grantees, or
other person(s) who will actually collect or analyze the information for the agency.
Self-explanatory.
OIRA has produced a number of documents that may serve as useful reference material
for completing Supporting Statement Part B. These can be found at
http://www.whitehouse.gov/omb/inforeg_statpolicy/.

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APPENDIX J: SAMPLE APPROVED PUBLIC BURDEN STATEMENT
Public Burden Statement
The public reporting burden for this information collection is estimated to be 30 minutes.
This burden estimate includes time for reviewing instructions, researching existing data
sources, gathering and maintaining the needed data, and completing and submitting the
information. Send comments regarding the accuracy of this burden estimate and any
suggestions for reducing the burden to: U.S. Office of Personnel Management, Federal
Investigative Services, Attn: OMB Number (3206-0246), 1900 E Street NW,
Washington, DC 20415-7900. You are not required to respond to this collection of
information unless a valid OMB control number is displayed.

United StateS �
Office Of PerSOnnel ManageMent �
Chief Information Officer
1900 E Street, NW
Washington, DC 20415

CIO/RM-02

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