USCG Academy Application and Supplemental Forms

OMB Control No: 1625-0004	ICR Reference No: 201601-1625-002
Status: Historical Active	Previous ICR Reference No: 201205-1625-008
Agency/Subagency: DHS/USCG	Agency Tracking No:
Title: USCG Academy Application and Supplemental Forms
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/29/2016
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/28/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved
Responses	2,500	0	0
Time Burden (Hours)	21,750	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This collection contains the application and all supplemental forms required to be considered as an applicant to the United States Coast Guard Academy. Additional information may be requested, but no new or pre-existing OMB approved forms are used.

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Authorizing Statute(s): US Code: 14 USC 211 Name of Law: Original appointment of permanent commissioned officers    US Code: 14 USC 181 Name of Law: Administration of Academy

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 42510	07/17/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 1635	01/13/2016
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 USCG Academy Application and Supplemental Forms CGA-14, CGA-14A, CGA-14B, CGA-14D Coast Guard Academy Forms

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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	2,500	0	0	-2,000	0	4,500
Annual Time Burden (Hours)	21,750	0	0	-2,500	0	24,250
Annual Cost Burden (Dollars)	0	0	0	-2,500	0	2,500

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The change (i.e., decrease) in burden is a PROGRAM CHANGE. The decrease in burden hours is due to the discontinuation of CGA-14C, Coach/Physical Education Instructor Evaluation form. The decrease in burden cost is due to exclusive use of e-forms for online submission of all supplemental forms, so no information is required to be submitted via U.S. mail. Updates are provided for cost burden associated with this collection of information. Overall, this collection of forms is easier for the respondents to complete and record keepers to process compared to the previous collection due to the technology employed within the e-forms and online review of all applicants and supplemental forms by USCGA.

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Annual Cost to Federal Government: $130,200

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: Chris McMunn 8607016778

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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: 01/28/2016

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