Application for Senior Administrative Law Judge & Geographic Preference Statement for Senior Administrative Law Judge

ICR 201805-3206-004

OMB: 3206-0248

Federal Form Document

ICR Details
3206-0248 201805-3206-004
Active 201410-3206-002
OPM
Application for Senior Administrative Law Judge & Geographic Preference Statement for Senior Administrative Law Judge
Revision of a currently approved collection   No
Regular
Approved with change 09/25/2018
Retrieve Notice of Action (NOA) 06/06/2018
This collection is approved based on the revised materials provided by the Agency.
  Inventory as of this Action Requested Previously Approved
09/30/2021 36 Months From Approved 09/30/2018
350 0 350
161 0 167
0 0 0

OPM 1655 and OPM 1655A will be used by retired Administrative Law Judges seeking reemployment to complete hearings in accordance with the Administrative Procedures Act of 1946. These forms streamline the application process by providing all needed information on 2 forms. The forms have changed to only to include updated regional selections.

US Code: 5 USC 3323(b) Name of Law: null
  
None

Not associated with rulemaking

  79 FR 44872 08/01/2014
79 FR 64421 10/29/2014
No

  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 350 350 0 0 0 0
Annual Time Burden (Hours) 161 167 0 -6 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
There is an increase of usage of both forms as well as both forms receiving changes to clarify instructions and streamline the completion.

$7,607
No
    Yes
    Yes
No
No
No
Uncollected
Demetrius Jones 202 606-5203 demetrius.jones@opm.gov

  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.
06/06/2018


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