THIS FORM IS NECESSARY FOR THE
DOCUMENTATION ON READMITS, SUCH AS REASONS FOR TERMINATING AND
CENTER WHICH TERMINATED THEM. ADDITIONALLY, USE OF THE FORM SAVES
THE TIME AND PAPERWORK FROM FILLING OUT ALL THE SCREENING OVER
AGAIN. IT IS USED ONLY WHEN THE SCREENER CAN PROVIDE SUBSTANTIVE
EVIDENCE TO DEMONSTRATE THAT THE APPLICANT HAS MOTIVATION AND
POTENTIAL TO COMPLETE THE PROGRAM.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.