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pdfPAPERWORK REDUCTION ACT SUBMISSION
Please read the instructions before completing this form. For additional forms or assistance in completing this form, contact your agency's Paperwork
Clearance Officer. Send two copies of this form, the collection instrument to be reviewed, the Supporting Statement, and any additional documentation
to: Office of Information and Regulatory Affairs, Office of Management and Budget, Docket Library, Room 10102, 725 17th Street NW,
Washington, DC 20503.
1. Agency/Subagency originating request
2. OMB control number
None
1110
__ __ __ - __0050
__ __ __
a. __ __
Federal Bureau of Investigation
3. Type of information collection (check one)
__ __ __ __
4. Type of review requested (check one)
a. ✔ Regular
New Collection
b. ✔ Revision of a currently approved collection
a.
c.
d.
Extension of a currently approved collection
Reinstatement, without change, of a previously approved
e.
collection for which approval has expired
Reinstatement, with change, of a previously approved
b.
Emergency - Approval requested by: ____/____/____
c.
Delegated
5. Small entities
Will this information collection have a significant economic impact on a
substantial number of small entities?
collection for which approval has expired
Yes
Existing collection in use without an OMB control number
f.
b.
No
✔
6. Requested expiration date
For b-f, note Item A2 of Supporting Statement instructions
a.
✔
Three years from the approval date
b.
_____/_____
7. Title
FBI National Academy Level I Evaluation
8. Agency form number(s) (if applicable)
9. Keywords
FBI National Academy, Law Enforcement Education, Law Enforcement Training, Training Programs
10. Abstract
The FBI National Academy plans to conduct a Level I Evaluation. Its purpose is to determine the strengths and weakness of
the program by measuring the student's reaction to the training program.
11. Affected public (Mark primary with "P" and all others with "X")
12. Obligation to respond (Mark primary with "P" and all others that apply with "X")
a. P Voluntary
Required to obtain or retain benefits
b.
a. __ Individuals or households
d. __ Farms
b. __ Business or other for-profit
x Federal Government
e. __
c. __ Not-for-profit institutions
P State, Local, or Tribal Government
f. __
13. Annual reporting and recordkeeping hour burden
a. Number of respondents
Mandatory
c.
14. Annual reporting and recordkeeping cost burden(in thousands of dollars)
b. Total annual responses
b. Total annual costs (O&M)
1. Percentage of these responses
collected electronically
c. Total annual hours requested
d. Current OMB inventory
c. Total annualized cost requested
100
%
d. Current OMB inventory
e. Difference
2080
0
f. Explanation of difference
e. Difference
1. Program change
f. Explanation of difference
2. Adjustment
1. Program change
x
x
2. Adjustment
15. Purpose of information collection (Mark primary with "P" and all others
16. Frequency of recordkeeping or reporting(check all that apply)
a. __ Application for benefits
Recordkeeping
e. __ Program planning or management c. ✔ Reporting:
X Program evaluation
b. __
f. __ Research
that apply with "X")
0
0
0
0
0
a. Total annualized capital/startup costs
1040
1040
a.
c. __ General purpose statistics g. __ Regulatory or compliance
d. __ Audit
On occasion
1.
4. ✔ Quarterly
Biennially
7.
b.
Third party disclosure
2.
Weekly
5.
8.
Semi-annually 6.
Annually
Other (describe) ____________
3.
Monthly
18. Agency contact (person who can best answer questions regarding the content
17. Statistical methods
Does this information collection employ statistical methods?
Yes ✔ No
of this submission)
Laleatha Goode
Name: ______________________________________________________
703-632-3495
Phone: ______________________________________________________
OMB 83-I
10/95
19. Certification for Paperwork Reduction Act Submissions
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with
5 CFR 1320.9.
NOTE: The text of 5 CFR 1320.9, and the related provisions of 5 CFR 1320.8(b)(3), appear at the end of the
instructions. The certification is to be made with reference to those regulatory provisions as set forth in
the instructions.
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) If 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 (see note in Item 19 of the instructions);
(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 below and explain the reason in
Item 18 of the Supporting Statement.
Signature of Senior Official or designee
Laleatha B. Goode
OMB 83-I
Date
03/13/2013
10/95
File Type | application/pdf |
File Title | Paperwork Reduction Act Submission (OMB 83-I) |
Subject | Paperwork Reduction Act Submission (OMB 83-I) |
Author | OMB |
File Modified | 2013-03-14 |
File Created | 1999-03-02 |