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Federal forms, ICRs, and supporting documents

Information Collection Request

Government, Corporate or Foundation, and Individual Donor Form Application

ICR 201710-1405-002 · OMB 1405-0218 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form DS-4271 Government, Corporate or Foundation, and Individual Donor Form Applications Form and Instruction Modified Repair queued
Legal Authorities Gifts.docx Supplementary Document Uploaded 2017-10-18 Repair queued
Final - Supporting Statement.docx Supporting Statement A Uploaded 2017-10-18 Available
IC Document Collections
IC IDCollectionTypeStatusForm
214454 Government, Corporate or Foundation, and Individual Donor Form Applications Form and Instruction Modified
ICR Details
1405-0218 201710-1405-002
Active 201412-1405-002
STATE/AFA
Government, Corporate or Foundation, and Individual Donor Form Application
Extension without change of a currently approved collection   No
Regular
Approved without change 12/05/2017
Retrieve Notice of Action (NOA) 10/18/2017
  Inventory as of this Action Requested Previously Approved
12/31/2020 36 Months From Approved 12/31/2017
4,333 0 3,665
361 0 305
2,123 0 1,833
The Office of Emergencies in the Diplomatic and Consular Services (EDCS) manages the solicitation and acceptance of gifts to the U.S. Department of State. The information requested via donor forms is a necessary first step in accepting donations. The information sought is pursuant to 22 U.S.C 2697, 5 U.S.C. 7342 and 22 CFR, Part 3.
US Code: 5 USC 7342 Name of Law: Foreign Gifts and Decorations Act
   US Code: 22 USC 2697 Name of Law: State Department Basic Authorities Act of 1956
  
None
Not associated with rulemaking
  82 FR 31386 07/06/2017
82 FR 48307 10/17/2017
No
1
IC Title Form No. Form Name
Government, Corporate or Foundation, and Individual Donor Form Applications DS-4271, DS-4272, DS-4273 Donor Form - Government ,   Donor Form - Corporate or Foundation ,   Donor Form - Individual
  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 4,333 3,665 0 668 0 0
Annual Time Burden (Hours) 361 305 0 56 0 0
Annual Cost Burden (Dollars) 2,123 1,833 0 290 0 0
Yes
Miscellaneous Actions
No
There was a slight increase in the burden hours associated with this collection, from 305 hours to 361, due to an increase of 56 donations since the last time this collection was approved
$30,482
No
    No
    Yes
No
No
No
Uncollected
Frances Gidez 202 647-6286 [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.
10/18/2017