OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Partnerships with Faith-Based and Other Neighborhood Organizations

ICR 201603-1291-002 · OMB 1291-0006 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
1291-0006_SSA_20160404.docx Supporting Statement A Uploaded 2016-04-04 Available
IC Document Collections
IC IDCollectionTypeStatusForm
215989 Refer Beneficiary or Potential Beneficiary Alternate Provider Unchanged
215988 Written Notice to Beneficiaries Instruction Modified
ICR Details
1291-0006 201603-1291-002
Historical Active 201504-1291-001
DOL/OASAM
Partnerships with Faith-Based and Other Neighborhood Organizations
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/29/2016
Retrieve Notice of Action (NOA) 04/04/2016
  Inventory as of this Action Requested Previously Approved
06/30/2019 36 Months From Approved
38 0 0
9 0 0
0 0 0
Executive Order 13559, Fundamental Principles and Policymaking Criteria for Partnerships with Faith-Based and Other Neighborhood Organizations caused the US Department of Labor (DOL) to propose a rule that amends the equal treatment provisions at 29 CFR Part 2 subpart D. This information collection describes the categories and extent of burden that respondents will incur as a result of DOL's implementation of this rule.
EO: EO 13559 Name/Subject of EO: Fundamental Principles & Policymaking Criteria for Partnerships w/ Faith-Based & Other Neighboorhood
  
EO: EO 13559 Name/Subject of EO: Fundamental Principles & Policymaking Criteria for Partnerships w/ Faith-Based & Other Neighboorhood
1290-AA29 Final or interim final rulemaking 81 FR 19355 04/04/2016
  80 FR 47328 08/06/2015
80 FR 47328 08/06/2015
Yes
2
IC Title Form No. Form Name
Refer Beneficiary or Potential Beneficiary Alternate Provider
Written Notice to Beneficiaries
  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 38 0 38 0 0 0
Annual Time Burden (Hours) 9 0 9 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a new information collection.
$82
No
No
No
No
No
Uncollected
Michel Smyth 202 693-0638 [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.
04/04/2016