OGIS Consent to Make Inquiries and Release of Information and Records

Forms and Documents

Document Name	Status
Form NA Form 10003 OGIS Consent to Make Inquiries and Release of Information and Records Form and Instruction	Modified
SupportingStatement for NA 10003_September_2016_FINAL.docx Supporting Statement A	2016-09-22

IC Document Collections

IC ID	Document Title	Status
194856	OGIS Consent to Make Inquiries and Release of Information and Records Form and Instruction	Modified

ICR Details

OMB Control No: 3095-0068	ICR Reference No: 201609-3095-001
Status: Historical Active	Previous ICR Reference No: 201402-3095-001
Agency/Subagency: NARA	Agency Tracking No:
Title: OGIS Consent to Make Inquiries and Release of Information and Records
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: 12/23/2016
	Date Received in OIRA: 09/22/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved	12/31/2016
Responses	400	0	600
Time Burden (Hours)	13	0	10
Cost Burden (Dollars)	0	0	0

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Abstract: In order to fulfill its government-wide statutory mission, OGIS provides varying types of assistance to its customers, which requires communicating with government departments and agencies regarding the customers’ FOIA/Privacy Act request/appeal. Handling requests for OGIS Assistance must conform to the legal requirements of the Freedom of Information Act (FOIA) and the Privacy Act of 1974. Authority for the requirements set forth in this form is also contained in 5 U.S.C. 552a(b). OGIS will use the information submitted in the proposed form to provide the requested assistance. Without the information submitted in this form, OGIS would be unable to fulfill its mission.

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Authorizing Statute(s): None

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:
	81 FR 40353	06/21/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 62538	09/09/2016
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
OGIS Consent to Make Inquiries and Release of Information and Records	NA Form 10003	OGIS Consent to Make Inquiries and Release of Information and Records

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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	400	600	0	-200	0	0
Annual Time Burden (Hours)	13	10	0	3	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: There is a slight change in burden, from 10 hours to 13 hours as the estimated time to complete the form has increased from one minute to two minutes.

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Annual Cost to Federal Government: $0

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: 09/22/2016

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