Certification of Compliance with Mandatory Bars to Employment

ICR 202108-3064-004

OMB: 3064-0121

Federal Form Document

IC Document Collections
ICR Details
3064-0121 202108-3064-004
Received in OIRA 201808-3064-002
FDIC
Certification of Compliance with Mandatory Bars to Employment
Extension without change of a currently approved collection   No
Regular 12/21/2021
  Requested Previously Approved
36 Months From Approved 12/31/2021
528 500
88 83
0 0

Prior to an offer of employment, job applicants to the FDIC must sign a certification that they have not been convicted of a felony or been in other circumstances that prohibit persons from becoming employed by or providing services to the FDIC.

None
None

Not associated with rulemaking

  86 FR 62812 09/22/2021
86 FR 72234 12/21/2021
No

1
IC Title Form No. Form Name
Certification of Compliance with Mandatory Bars to Employment FDIC-2120/16 Applicant Certification Statement

  Total Request 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 528 500 0 0 28 0
Annual Time Burden (Hours) 88 83 0 0 5 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
No
Manuel Cabeza 202 898-3781 mcabeza@fdic.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.
12/21/2021


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