USDA PIV Request for Credential

ICR 201702-0505-001

OMB: 0505-0022

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supplementary Document
2017-02-13
Supporting Statement A
2017-02-13
Supplementary Document
2017-02-13
Supplementary Document
2017-02-13
Supplementary Document
2017-02-13
Supplementary Document
2017-02-13
Supplementary Document
2017-02-13
IC Document Collections
IC ID
Document
Title
Status
985 Modified
ICR Details
0505-0022 201702-0505-001
Historical Active 201308-0505-001
USDA/OCFO
USDA PIV Request for Credential
Extension without change of a currently approved collection   No
Regular
Approved without change 04/11/2017
Retrieve Notice of Action (NOA) 02/13/2017
  Inventory as of this Action Requested Previously Approved
04/30/2020 36 Months From Approved 04/30/2017
12,000 0 12,000
30,000 0 30,000
0 0 0

This form collects information related to USDA employees, contractors, and non-employee affiliates applying for a USDA credential (identification card), in accordance with Homeland Security Presidential Directive 12 and Federal Information Processing Standard 201.

PL: Pub.L. 110 - 53 523 Name of Law: The Implementing the 9/11 Recommendtions Act of 2007
  
None

Not associated with rulemaking

  81 FR 87903 12/06/2016
82 FR 10450 02/13/2017
No

1
IC Title Form No. Form Name
USDA PIV Request for Credential AD-1197 Request for USDA Identification (ID) Badge

  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 12,000 12,000 0 0 0 0
Annual Time Burden (Hours) 30,000 30,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$157,320
No
No
No
No
No
Uncollected
Richard Holman 2027203901

  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.
02/13/2017


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