Labor Organization Officer and Employee Report, Form LM-30 (Revised 2011)

Forms and Documents

Document Name	Status
Form LM-30 Form LM-30 (Revised 2011) Form	New
Revised LM-30 Instructions (2011 - Final).pdf Supplementary Document	2011-09-29
Revised LM-30 Form (2011 - Final).pdf Supplementary Document	2011-09-29
Note_to_Reviewer_LM-30_(6-3-11).doc Supplementary Document	2011-08-16
Supporting_Statement_Revised_Form_LM-30_(Final 20110816).doc Supporting Statement A	2011-09-20

IC Document Collections

IC ID	Document Title	Status
198016	Form LM-30 (Revised 2011) Form	New

ICR Details

OMB Control No: 1245-0005	ICR Reference No: 201110-1245-001
Status: Historical Active	Previous ICR Reference No: 201106-1245-005
Agency/Subagency: DOL/OLMS	Agency Tracking No:
Title: Labor Organization Officer and Employee Report, Form LM-30 (Revised 2011)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/26/2011
	Date Received in OIRA: 10/26/2011
Terms of Clearance: DOL is reminded that the PRA requires collections associated with proposed rules to be submitted to OMB for review at the proposed rule stage.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2014	36 Months From Approved
Responses	1,932	0	0
Time Burden (Hours)	2,898	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Labor-Management Reporting and Disclosure Act (LMRDA) requires labor organization officers and employees to disclose potential conflicts of interest between the labor organization officials and their labor organization. The Department of Labor established the Form LM-30, Labor Organization Officer and Employee Report, pursuant to this LMRDA requirement. All reports are available for public disclosure. Filers are required to retain supporting records for five years.

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Authorizing Statute(s): US Code: 29 USC 432 Name of Law: Labor-Management Reporting and Disclosure Act
   US Code: 29 USC 436 Name of Law: Labor-Management Reporting and Disclosure Act
   US Code: 29 USC 438 Name of Law: Labor-Management Reporting and Disclosure Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1245-AA01	Final or interim final rulemaking	76 FR 66442	10/26/2011

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Form LM-30 (Revised 2011)	LM-30	LM-30

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ICR Summary of Burden

	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	1,932	0	0	1,932	0	0
Annual Time Burden (Hours)	2,898	0	0	2,898	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Department is seeking a new information collection for the revised Form LM-30.

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Annual Cost to Federal Government: $6,490,504

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/21/2011

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