OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Senior Administrative Law Judge & Geographic Preference Statement for Senior Administrative Law Judge

ICR 201410-3206-002 · OMB 3206-0248 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form OPM 1655A Geographic Preference Statement for Senior Administrative Law Judge Applicant Form and Instruction Modified Repair queued
Form OPM 1655 Application for Senior Administrative Law Judge Form and Instruction Modified Available
2014-25688 30 Day Notice.pdf Supplementary Document Uploaded 2014-10-30 Available
2014-18187 60 Day Notice.pdf Supplementary Document Uploaded 2014-10-30 Available
3206-0248 Supporting Statement - Senior ALJ Forms 1655 and 1655-A - 2014.doc Supporting Statement A Uploaded 2014-10-30 Available
IC Document Collections
IC IDCollectionTypeStatusForm
182393 Geographic Preference Statement for Senior Administrative Law Judge Applicant Form and Instruction Modified
182362 Application for Senior Administrative Law Judge Form and Instruction Modified
ICR Details
3206-0248 201410-3206-002
Historical Active 201108-3206-001
OPM
Application for Senior Administrative Law Judge & Geographic Preference Statement for Senior Administrative Law Judge
Revision of a currently approved collection   No
Regular
Approved without change 12/22/2014
Retrieve Notice of Action (NOA) 10/30/2014
  Inventory as of this Action Requested Previously Approved
12/31/2017 36 Months From Approved 12/31/2014
350 0 250
167 0 138
0 0 0
OPM 1655 and OPM 1655A will be used by retired Administrative Law Judges seeking reemployment to complete hearings in accordance with the Administrative Procedures Act of 1946. These forms streamline the application process by providing all needed information on 2 forms. The forms have changed to include updated regional selections.
US Code: 5 USC 3323(b) Name of Law: null
  
None
Not associated with rulemaking
  79 FR 44872 08/01/2014
79 FR 64421 10/29/2014
No
  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 350 250 0 100 0 0
Annual Time Burden (Hours) 167 138 0 29 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
There is an increase of usage of both forms as well as both forms receiving changes to clarify instructions and streamline the completion.
$59,219
No
No
No
No
No
Uncollected
Steve Pierce 202 606-2560 [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.
10/30/2014