Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay

Forms and Documents

Document Name	Status
Form 12311 Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay Form	Modified
Supporting Statement for 1545-1920.doc Supporting Statement A	2014-12-04

IC Document Collections

IC ID	Document Title	Status
19621	Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay Form	Modified

ICR Details

OMB Control No: 1545-1920	ICR Reference No: 201409-1545-012
Status: Historical Active	Previous ICR Reference No: 201110-1545-045
Agency/Subagency: TREAS/IRS	Agency Tracking No:
Title: Form 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/21/2015
	Date Received in OIRA: 12/31/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2018	36 Months From Approved	11/30/2015
Responses	6,624	0	33,085
Time Burden (Hours)	530	0	2,757
Cost Burden (Dollars)	0	0	0

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Abstract: Form 12311 outlines the regulations requiring those employees being rehired by the government and received a buyout from their previous job to make repayment of the buyout before they will be hired again.

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Authorizing Statute(s): PL: Pub.L. 104 - 208 224 Name of Law: Omnibus Consolidated Appropriations of 1997
   PL: Pub.L. 103 - 226 3 Name of Law: Federal Workforce Restructuring Act of 1994
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 38672	07/08/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 78565	12/30/2014
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 12311 - Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay	12311	Repayment of a Federal Government Buyout and Possible Suspension of Severance Pay

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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	6,624	33,085	0	0	-26,461	0
Annual Time Burden (Hours)	530	2,757	0	0	-2,227	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: There is a 2,227 decrease in the total burden hours previously approved by OMB due to an adjustment in agency estimate. Due to budget constraints, the agency expects to hire a smaller number of employees.

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Annual Cost to Federal Government: $2,950

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: 12/31/2014

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