Library Reviewer Form and Museum Reviewer Form

Forms and Documents

Document Name	Status
Form Museum Reviewer fo Museum Reviewer form Form and Instruction	Unchanged
Form OLS Peer Review 1 Library Reviewer form Form and Instruction	Modified
Justification for Change OLS Peer Reviewer Form 2017-10-05.docx Justification for No Material/Nonsubstantive Change	2017-10-05
SF-3881.pdf Supplementary Document	2016-06-17
NOA_3137-0071.pdf Supplementary Document	2016-06-17
Burden Estimate Library and Museum Reviewer Forms.xlsx Supplementary Document	2016-06-17
Forms Justification Statement A - Library and Museum Reviewer Forms.docx Supporting Statement A	2016-06-17

IC Document Collections

IC ID	Document Title	Status
222030	Museum Reviewer form Form and Instruction	Unchanged
222029	Library Reviewer form Form and Instruction	Modified

ICR Details

OMB Control No: 3137-0099	ICR Reference No: 201710-3137-002
Status: Historical Active	Previous ICR Reference No: 201606-3137-014
Agency/Subagency: IMLS	Agency Tracking No:
Title: Library Reviewer Form and Museum Reviewer Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/31/2017
	Date Received in OIRA: 10/06/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2018	07/31/2018	07/31/2018
Responses	1,778	0	1,778
Time Burden (Hours)	889	0	889
Cost Burden (Dollars)	24,839	0	24,839

---

Abstract: IMLS requests clearance for forms it uses for all of the grant program applications, post-award reporting, and peer reviewer applications. These forms are directly related to the generic clearance for IMLS grant application and award processes (3137-0029).

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 25	02/06/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 99	05/22/2015
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Library Reviewer form	OLS Peer Review 1	OLS Peer Review Form 2017
Museum Reviewer form	Museum Reviewer form 1	Museum Reviewer Form

---

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	1,778	1,778	0	0	0	0
Annual Time Burden (Hours)	889	889	0	0	0	0
Annual Cost Burden (Dollars)	24,839	24,839	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: No burden increase.

---

Annual Cost to Federal Government: $4,898

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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

---

Common Form ICR:  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:

(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: 10/06/2017

---