THIS FORM IS NECESSARY FOR THE
DOCUMENTATION OF INFORMATION ON READMISSIONS, SUCH AS REASON FOR
TERMINATING AND CENTER TERMINATED FRO USE OF THE FORM SAVES THE
TIME AND PAPERWORK OF FILLING OUT ALL OF THE SCREENING FROMS OVER
AGAIN. IT IS USED ONLY WHEN THE SCREENER CAN PROVIDE SUBSTANTIVE
EVIDENCE THAT THE APPLICANT HAS THE MOTIVATION AND POTENTIAL TO
COMPLETE THE PROGRAM IF READMITTED.
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.