Acquisition Services Information Requirements

OMB Control No: 3064-0072	ICR Reference No: 201211-3064-003
Status: Historical Active	Previous ICR Reference No: 200905-3064-002
Agency/Subagency: FDIC	Agency Tracking No:
Title: Acquisition Services Information Requirements
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/30/2012
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/28/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2015	36 Months From Approved	12/31/2012
Responses	6,035	0	6,035
Time Burden (Hours)	2,564	0	2,564
Cost Burden (Dollars)	0	0	0

---

Abstract: This is a collection of information involving the submission of various forms by contractors doing business with the FDIC.

---

Authorizing Statute(s): US Code: 12 USC 1819 Name of Law: Federal Deposit Insurance Act

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 58377	09/20/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 70778	11/27/2012
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 6

IC Title Form No. Form Name FDIC Past Performance Questionnaire 3700-57 FDIC Past Performance Questionnaire Contractor Representations and Certifications 3700/4A FDIC Contractor Representations and Certifications Background Investigation Questionnaire Contractors 1600-07 Background Investigation Questionnaire for Contractors Leasing Representations and Certifications 3700/44 Leasing Representations and Certifications Integrity and Fitness Representations 3700/12 FDIC Integrity and Fitness Representations and Certifications Background Investigation Questionnaire for Contractor Personnel & Subcontractors 3064-1600/04 Background Investigation Questionnaire for Contractor Personnel & Subcontractors

---

ICR Summary of Burden

	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	6,035	6,035	0	0	0	0
Annual Time Burden (Hours)	2,564	2,564	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Gary Kuiper 202 898-3877 [email protected]

---

Common Form ICR:  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:
		(a) It is necessary for the proper performance of agency functions;
		(b) It avoids unnecessary duplication;
		(c) It reduces burden on small entities;
		(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
		(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
		(f) It indicates the retention periods for recordkeeping requirements;
		(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
			(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;
		(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
		(i) It uses effective and efficient statistical survey methodology (if applicable); and
		(j) It makes appropriate use of information technology.
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.
Certification Date: 11/28/2012

---