Final Supporting Statement

SUPPORTING STATEMENT FOR
PAPERWORK REDUCTION ACT SUBMISSION

Government, Corporate or Foundation, and Individual Donor Form

Application

OMB Number 1405-0218
DS-4271, DS-4272, DS-4273

A. JUSTIFICATION

1. Why is this collection necessary and what are the legal statutes that allow this?

The Office of Emergencies in the Diplomatic and Consular Services (EDCS) manages the solicitation and acceptance of gifts to the U.S. Department of State. The information requested via donor forms is a necessary first step in accepting donations. The information sought is pursuant to 22 U.S.C 2697, 5 U.S.C. 7342 and 22 CFR, Part 3.

2. What business purpose is the information gathered going to be used for?

The information collected will be used by EDCS’s Gift Fund Coordinator to demonstrate the donor’s intention to donate either an in-kind or monetary gift to the Department. Collection of this information is mandatory, and a form must be completed before the gift is received by the Department.

3. Is this collection able to be completed electronically?

Donors can request and complete hard copies of the form from program offices who have authority to solicit and accept on behalf of the Department. After completion, all forms are mailed to EDCS. The Department intends to create an electronic submission option by the next collection renewal.

4. Does this collection duplicate any other collection of information?

EDCS is the only office in the Department managing the donor program so no other office or program is requesting duplicate information from the public.

5. Describe any impacts on small business.

This collection of information will not have a significant impact on small businesses or other small entities. Small businesses may give in-kind or cash gifts to the Department. The Department estimates it will take a small business five minutes to complete a form, put it in an envelope, address it, and mail it to the Department.

6. What are consequences if this collection is not done?

Without the information collection, EDCS would not be able to accept gifts from donors to the Department. The information is collected only once per donation.

7. Are there any special collection circumstances?

There are no special circumstances.

8. Document publication (or intent to publish) a request for public comments in the Federal Register

On August 4, 2020, EDCS published a notice in the Federal Register seeking public comments on this proposed collection. See 85 FR 47285. The public comment received was nonresponsive.

9. Are payments of gifts given to the respondents?

No gifts or payments will be made to respondents.

10. Describe assurances of privacy/confidentiality

All information will be handled in accordance with the Privacy Act. The Department has made no promises of confidentiality to the respondents.

11. Are any questions of a sensitive nature asked?

No questions of a sensitive nature are asked.

12. Describe the hour time burden and the hour burden of the respondent needed to complete this collection

EDCS estimates an average time required for this information collection is 10 minutes. The estimated total annual burden for this collection:

4,079 (estimated respondents for FY19) x 10 (minutes per form) / 60 = 680 hours per year.

The estimated number of minutes required per response is based on typed or written information required on the appropriate donor form: Government, Corporate or Foundation, and Individual. The donor must complete all required fields on the form, review both pages, and mail or email the document. EDCS increased the estimated number of minutes per response from 5 minutes to 10 minutes after further assessment of the process. Forms that are mailed require a forwarding and return address, envelope, postage, and postal carrier. The donor may opt to email the completed form to the program office responsible for accepting the donation. The program office will forward the package to EDCS for processing.

The hourly cost to respondents for the donor forms are calculated by the hourly wage and weighted multiplier. The wage rate category for “All Occupation”, $25.72 (mean hourly wage), based on the U.S. Department of Labor, Bureau of Labor Statistics website (www.bls.gov) x 1.8 wage rate multiplier¹ to account for employees benefits and overhead costs.

$25.72 x 1.84 = $46.30 wage rate

680 (annual hours) x $40.36 (wage rate) = $31.48 yearly hour burden cost

13. Describe the monetary burden to respondents (out of pocket costs) needed to complete this collection.

There will be no capital or start-up costs necessary for respondents. The only additional operation cost would be postage for the respondents to return the form to the Department. The cost of postage increased since the last renewal. The Department estimates 4,079 forms mailed at 55 cents each for a total of $2,243.

14. Describe the cost incurred by the Federal Government to complete this collection.

The estimated cost to the USG for the Donor Form collections is $101,699. The estimate includes costs for the Program Analyst GS-12, step 5 equivalent - $45.29 per hour². The Analyst will process each form – opening the envelope, recording the information in a database, and sending a letter of acknowledgment back to the donor. Additional costs include employees benefits and overhead costs to the employer (supplies).

Total Cost to Federal Government

Cost Items	Total
Federal Staff Costs [indicate grade and step, percentage of time] GS-12, Step 5 equivalent - $45.29/hour x 2 @ estimated 40 hours total	$94,203
Employee Benefits	$7,014.12
Supplies (address labels, envelops, postage)	$481.80
Total	$101,699

15. Explain any changes/adjustments to this collection since the previous submission

Since the previous renewal, donations from government, individuals, corporations, and foundations slightly decreased by 6%. Donations vary due to political, environmental, and economic stability.

16. Specify if the data gathered by this collection will be published.

The information gathered via this information collection will not be published.

17. If applicable, explain the reason(s) for seeking approval to not display the OMB expiration date.

EDCS will display the OMB expiration date on hard copy and electronic versions of the forms.

18. Explain any exceptions to the OMB certification statement below.

EDCS does not request an exception to the certification of the information collection.

B. COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS

This information collection does not employ statistical methods.

1 Source: U.S. Bureau of Labor Statistics, March 2019, https://www.bls.gov/oes/current/oes_nat.htm#00-0000. National Occupational Employment and Wage Estimates for “All Occupations”.

2 Source: Office of personnel Management, “2019 General Schedule and Locality pay” for Washington-Baltimore-Arlington, DC-MD, VA-PA. https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2019/DCB_h.pdf