OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Certification of Compliance with Mandatory Bars to Employment

ICR 201203-3064-006 · OMB 3064-0121 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form FDIC-2120/16 Certification of Compliance with Mandatory Bars to Employment Form Modified Available
2012-18995.pdf Supplementary Document Uploaded 2012-08-03 Available
SPST_0121_2012.doc Supporting Statement A Uploaded 2012-07-30 Available
2012-05-30_notice.pdf Supplementary Document Uploaded 2012-07-30 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
31915 Certification of Compliance with Mandatory Bars to Employment Form Modified
ICR Details
3064-0121 201203-3064-006
Historical Active 200903-3064-002
FDIC
Certification of Compliance with Mandatory Bars to Employment
Extension without change of a currently approved collection   No
Regular
Approved without change 09/13/2012
Retrieve Notice of Action (NOA) 08/03/2012
  Inventory as of this Action Requested Previously Approved
09/30/2015 36 Months From Approved 09/30/2012
600 0 600
100 0 99
0 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
  77 FR 31854 05/30/2012
77 FR 46434 08/03/2012
No
1
IC Title Form No. Form Name
Certification of Compliance with Mandatory Bars to Employment FDIC-2120/16 Applicant Certification Statement
  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 600 600 0 0 0 0
Annual Time Burden (Hours) 100 99 0 0 1 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The change of +1 hour reflects an adjustment arising from calculating the response time in minutes rather than as a fraction of an hour.
$0
No
No
No
No
No
Uncollected
Leneta Gregorie 202 898-3719 [email protected]
  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.
08/03/2012