Request for Arbitration Services

OMB Control No: 3076-0002	ICR Reference No: 201508-3076-002
Status: Historical Inactive	Previous ICR Reference No: 201107-3076-002
Agency/Subagency: FMCS	Agency Tracking No:
Title: Request for Arbitration Services
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Improperly submitted	Conclusion Date: 10/19/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/20/2015
Terms of Clearance: Returned to FMCS for re-submission as a regular, non-generic ICR.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Form R-43, Request for Arbitration Services, is used by labor union and employer parties to collective bargaining agreements, and in fact-finding and interest arbitration cases, to request FMCS to furnish a list of arbitrators from its roster. The parties then select an arbitrator from the list to hear and resolve their dispute.

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Authorizing Statute(s): US Code: 29 USC 171 (b) Name of Law: Labor Management Relations Act

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 23550	04/28/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 43089	07/21/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title Form No. Form Name Request for Arbitration Services FMCS Form R-43 Request for Arbitration Panel

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Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Form R-43, Request for Arbitration Services, is used by labor union and employer parties to collective bargaining agreements, and in fact-finding and interest arbitration cases, to request FMCS to furnish a list of arbitrators from its roster. The parties then select an arbitrator from the list to hear and resolve their dispute.

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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: Jeannette Walters-Marquez 202 606-5488 [email protected]

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Common Form ICR:  No

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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: 08/20/2015

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