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Federal forms, ICRs, and supporting documents

Information Collection Request

National Defense Executive Reserve Personal Qualification Statement

ICR 199908-3067-004 · OMB 3067-0001 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
31971 National Defense Executive Reserve Personal Qualification Statement Form Migrated
ICR Details
3067-0001 199908-3067-004
Historical Active 199605-3067-001
FEMA
National Defense Executive Reserve Personal Qualification Statement
Revision of a currently approved collection   No
Regular
Approved without change 03/04/2000
Retrieve Notice of Action (NOA) 08/30/1999
This collection is approved with the following changes and clarifications: -- This collection is not voluntary; it is required to obtain a benefit, in this case, membership in the NDER. The disclosure statements on the form must be changed accordingly. -- A statement is required for the SSN. The form must state whether the SSN is required for consideration of the application, if so, under what statutory authority, and what specific use will be made of the SSN. Under the routine uses listed on the current form, the SSN may not be used to conduct a Name Check through any other Federal agency. -- The form must inform the respondent of the significance of the OMB number.
  Inventory as of this Action Requested Previously Approved
03/31/2003 03/31/2003 03/31/2000
50 0 100
25 0 50
0 0 0
The NDER is a Federal Government program coordinated by FEMA. The program provides a reserve of highly qualified individuals from industry, organized labor, professional groups, and academia to serve in executive positions in time of a national emergency. FEMA form 85-3 National Defense Executive Reserve (NDER) Qualifications Statement is used to apply for membership as an Executive Reservist, in lieu of Application for Employment in the Federal Government (SF-171) qualification statement.
None
None
No
1
IC Title Form No. Form Name
National Defense Executive Reserve Personal Qualification Statement FEMA-85-3
  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 50 100 0 0 -50 0
Annual Time Burden (Hours) 25 50 0 0 -25 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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.
08/30/1999