OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Application for Employment as a Locally Employed Staff or Family Member

ICR 201710-1405-003 · OMB 1405-0189 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form DS-174 Application for Employment as a Locally Employed Staff or Family Member Form and Instruction Modified Repair queued
Justification for Non-substantive change in DS 174.docx Justification for No Material/Nonsubstantive Change Uploaded 2017-10-23 Repair queued
Justification for Non-substantive Change.pdf Justification for No Material/Nonsubstantive Change Uploaded 2017-04-17 Repair queued
DIR Review - Legal Authorities.docx Supplementary Document Uploaded 2016-03-31 Available
Final - PRA Supporting Statement.doc Supporting Statement A Uploaded 2017-05-19 Available
IC Document Collections
IC IDCollectionTypeStatusForm
190750 Application for Employment as a Locally Employed Staff or Family Member Form and Instruction Modified
ICR Details
1405-0189 201710-1405-003
Historical Active 201704-1405-003
STATE/AFA
Application for Employment as a Locally Employed Staff or Family Member
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 11/15/2017
Retrieve Notice of Action (NOA) 10/23/2017
  Inventory as of this Action Requested Previously Approved
05/31/2019 05/31/2019 05/31/2019
40,000 0 40,000
40,000 0 40,000
12,500 0 12,500
This form will be used by candidates for employment for positions established and recruited by the approximately 170 Department of State Missions abroad. These programs generate approximately 40,000 applications per year. Data extracted from the form is necessary to determine eligibility, qualification, and selection for overseas employment, according to Federal policies.
PL: Pub.L. 96 - 465 103,105.206,301,303,311,408 Name of Law: Foreign Service Act of 1980
   US Code: 22 USC 2669(c) Name of Law: Foreign Relations and Intercourse
  
None
Not associated with rulemaking
  81 FR 3230 01/20/2016
81 FR 18680 03/31/2016
No
  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 40,000 40,000 0 0 0 0
Annual Time Burden (Hours) 40,000 40,000 0 0 0 0
Annual Cost Burden (Dollars) 12,500 12,500 0 0 0 0
No
No
$907,203
No
    Yes
    Yes
No
No
No
Uncollected
Caroline Cole 202 203-7390 [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.
10/23/2017