Certificate of Medical Examination

ICR 202206-0583-003

OMB: 0583-0167

Federal Form Document

Forms and Documents
IC Document Collections
IC ID
Document
Title
Status
218023 Modified
ICR Details
0583-0167 202206-0583-003
Received in OIRA 202005-0583-002
USDA/FSIS
Certificate of Medical Examination
Revision of a currently approved collection   No
Regular 09/27/2022
  Requested Previously Approved
36 Months From Approved 11/30/2022
1,250 800
1,542 809
0 0

to collect certificates of medical examination to determine whether or not an applicant for an FSIS Food Inspector, Consumer Safety Inspector, or Veterinary Medical Officer in-plant position meets the Office of Personnel Management (OPM) approved medical qualification standards and to collection information for requests for reasonable accommodations

US Code: 21 USC 451 Name of Law: Poultry Products Inspection Act
   US Code: 21 USC 1031 Name of Law: Egg Products Inspection Act
   US Code: 21 USC 601 Name of Law: Federal Meat Inspection Act
  
None

Not associated with rulemaking

  87 FR 42991 07/19/2022
87 FR 58475 09/27/2022
Yes

  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 1,250 800 0 450 0 0
Annual Time Burden (Hours) 1,542 809 0 733 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The Agency has increased the total burden estimate for the collection by 733 hours due an increase in hiring. The Agency also held more training on reasonable accommodation which caused an increase in the number of applications for reasonable accommodation. FSIS added 500 respondents for the FSIS Form 4339-1, and 200 respondents for the FSIS Form 4306-5.

$18,753
No
    Yes
    Yes
No
No
No
No
Gina Kouba 202 690-6510 gina.kouba@fsis.usda.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.
09/27/2022


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