Native American Basic Library Grant Final Performance Report Form

Forms and Documents

Document Name	Status
Form NA Basic Performan Native American Library Services Basic Grants Performance Reporting Form Form and Instruction	New
Burden Estimate NA Basic Financial Performance report 2019-01-31.xlsx Supplementary Document	2019-01-31
Forms Justification Statement A - Native American Basic Library Performance.docx Supporting Statement A	2019-01-31
Final_Justification for Change_NAG-Budget A & B.docx Justification for No Material/Nonsubstantive Change	2017-01-20
Burden Estimate NA Basic Budget A&B Final Financial Performance report.xlsx Supplementary Document	2016-06-16
Administration _ Manage_Award-Forms.pdf Supplementary Document	2016-06-16
NOA_3137-0071-July2015.pdf Supplementary Document	2016-06-16

IC Document Collections

IC ID	Document Title	Status
234796	Native American Library Services Basic Grants Performance Reporting Form Form and Instruction	New

ICR Details

OMB Control No: 3137-0098	ICR Reference No: 201901-3137-004
Status: Historical Active	Previous ICR Reference No: 201701-3137-002
Agency/Subagency: IMLS	Agency Tracking No:
Title: Native American Basic Library Grant Final Performance Report Form
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: 03/14/2019
	Date Received in OIRA: 01/31/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	36 Months From Approved	03/31/2019
Responses	380	0	380
Time Burden (Hours)	475	0	475
Cost Burden (Dollars)	13,457	0	13,457

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Abstract: IMLS is requesting a new three year clearance for the Performance Reporting form used in the Native American Basic Library Grant program.

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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:
	83 FR 60505	11/26/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 802	01/31/2019
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
Native American Library Services Basic Grants Performance Reporting Form	NA Basic Performance Form 1	FY19 Native American Basic Grant Performance Form

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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	380	380	0	0	0	0
Annual Time Burden (Hours)	475	475	0	0	0	0
Annual Cost Burden (Dollars)	13,457	13,457	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:

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Annual Cost to Federal Government:

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

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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: 01/31/2019

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