REQUEST FOR PERSONAL IDENTITY VERIFICATION CARD

ICR 200905-2900-001

OMB: 2900-0673

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2009-06-17
Supporting Statement A
2009-06-15
IC Document Collections
IC ID
Document
Title
Status
44129 Modified
ICR Details
2900-0673 200905-2900-001
Historical Active 200606-2900-002
VA 2900-0673
REQUEST FOR PERSONAL IDENTITY VERIFICATION CARD
Extension without change of a currently approved collection   No
Regular
Approved without change 08/19/2009
Retrieve Notice of Action (NOA) 06/18/2009
  Inventory as of this Action Requested Previously Approved
08/31/2012 36 Months From Approved 08/31/2009
100,000 0 100,000
8,333 0 8,333
0 0 0

Employees and contractors must complete Section 1A of the 0711 form to start the PIV Card issuance/re-issuance process and to ultimately receive a PIV Card.

None
None

Not associated with rulemaking

  74 FR 59 03/30/2009
74 FR 112 06/12/2009
No

1
IC Title Form No. Form Name
REQUEST FOR PERSONAL IDENTITY VERIFICATION CARD 0711 Request for Personal Identity Verification Card

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100,000 100,000 0 0 0 0
Annual Time Burden (Hours) 8,333 8,333 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$239,806
No
No
Uncollected
Uncollected
No
Uncollected
Denise McLamb 202-565-8374 denise.mclamb@mail.va.gov

  No

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.
06/18/2009


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