OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Gratuitous Services Agreement and Volunteer Release and Hold Harmless

ICR 201605-1670-002 · OMB 1670-0031 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
privacy-dhs-all-pia-006-update-June2016.pdf Supplementary Document Uploaded 2016-09-16 Available
PTA, NPPD - Gratuitous Services Agreement Volunteer Participant Release ....pdf Supplementary Document Uploaded 2016-09-16 Available
hr_5005_enr.pdf Supplementary Document Uploaded 2016-06-22 Available
USCODE-2010-title6-chap1-subchapII-partA-sec121 Infrastructure Protection access to information.pdf Supplementary Document Uploaded 2016-05-16 Available
Homeland Security Presidential Directive 19 (HSPD-19).pdf Supplementary Document Uploaded 2016-05-16 Repair queued
PPD 7 Homeland Security Presidential Directive 7 Critical Infrastructure Identification, Prioritization, and Protection.pdf Supplementary Document Uploaded 2016-05-16 Available
President’s Policy Directive-17 Countering Improvised Explosive Devices PPD-17.pdf Supplementary Document Uploaded 2016-05-16 Available
NSPD 17 - HSPD 4 (unclassified version) National Strategy to Combat Weapons of Mass Destruction..pdf Supplementary Document Uploaded 2016-05-16 Available
DHS-2015-0028-0002 published 30-day FRN v81 no25 pg6531-6532 2-8-2016.pdf Supplementary Document Uploaded 2016-05-16 Available
DHS-2015-0028-0001 1670-NEW OBP 60day published v80 no161 pg 50649 08-20-2015.pdf Supplementary Document Uploaded 2016-05-16 Repair queued
Supporting Statement A_Gratuitous Services_Volunteer Release V3 09-16-2016.doc Supporting Statement A Uploaded 2016-09-16 Available
IC Document Collections
IC IDCollectionTypeStatusForm
221540 Gratuitous Services Agreement and Volunteer Release and Hold Harmless Other-Form Agreement New
ICR Details
1670-0031 201605-1670-002
Historical Active
DHS/CISA
Gratuitous Services Agreement and Volunteer Release and Hold Harmless
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 03/06/2017
Retrieve Notice of Action (NOA) 09/20/2016
  Inventory as of this Action Requested Previously Approved
03/31/2020 36 Months From Approved
750 0 0
150 0 0
0 0 0
The purpose of the Volunteer Participant Release of Liability Agreement is to collect necessary information in case an individual who acts as a volunteer role player in support of official OBP training sustains an injury or death during the performance of his or her supporting role. If legal action is taken, this information can serve as a “hold harmless” statement /agreement by the Government. In the unlikely event that an injury or death is sustained in the performance of support for training, this information will be used by NPPD/IP/PSCD/OBP to protect against legal action by the volunteer or their family. If legal action is taken, this information can serve as a “hold harmless” statement /agreement by the Government.
PL: Pub.L. 107 - 296 6 U.S.C. § 121 Name of Law: Homeland Security Act - Section 201
  
None
Not associated with rulemaking
  80 FR 50649 08/20/2015
81 FR 6531 02/08/2016
No
1
IC Title Form No. Form Name
Gratuitous Services Agreement and Volunteer Release and Hold Harmless
  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 750 0 0 750 0 0
Annual Time Burden (Hours) 150 0 0 150 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection.
$6,831
No
No
No
No
No
Uncollected
Evette Maynard-Noel 571 294-3360 [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.
09/20/2016