Information Collection Request

USDA PIV Request for Credential

ICR 202004-0505-001 · OMB 0505-0022 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form AD-1197 USDA PIV Request for Credential Form Modified Available
FD-258.pdf Supplementary Document Uploaded 2020-04-17 Available
sf86.pdf Supplementary Document Uploaded 2020-04-16 Available
sf85p.pdf Supplementary Document Uploaded 2020-04-16 Available
sf85.pdf Supplementary Document Uploaded 2020-04-16 Repair queued
FAIR CREDIT REPORTING ACT OF 1970.pdf Supplementary Document Uploaded 2020-04-16 Available
SuptStmt Questions April_14_2020 0505-0022 (002).docx Supporting Statement A Uploaded 2020-04-17 Available
OF 306--FINAL-508 Compliant-IRS Developed-5-16-16.pdf Supplementary Document Uploaded 2020-04-17 Available
HSPD-12 Directive_001.pdf Supplementary Document Uploaded 2020-04-16 Available
IC Document Collections
IC IDCollectionTypeStatusForm
985 USDA PIV Request for Credential Form Modified
ICR Details
0505-0022 202004-0505-001
Active 201702-0505-001
USDA/OCFO
USDA PIV Request for Credential
Revision of a currently approved collection   No
Regular
Approved without change 05/20/2020
Retrieve Notice of Action (NOA) 04/17/2020
  Inventory as of this Action Requested Previously Approved
05/31/2023 36 Months From Approved 05/31/2020
12,000 0 12,000
24,000 0 30,000
0 0 0

This form collects information related to USDA employees, contractors, and non-employee affiliates applying for a USDA credential (identification card), in accordance with Homeland Security Presidential Directive 12 and Federal Information Processing Standard 201.

PL: Pub.L. 110 - 53 523 Name of Law: The Implementing the 9/11 Recommendtions Act of 2007
  
None

Not associated with rulemaking

  85 FR 3604 01/22/2020
85 FR 21386 04/17/2020
No

1
IC Title Form No. Form Name
USDA PIV Request for Credential AD-1197 Request for USDA Identification (ID) Badge

  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 12,000 12,000 0 0 0 0
Annual Time Burden (Hours) 24,000 30,000 0 0 -6,000 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$176,653
No
    Yes
    Yes
No
No
No
No
Su Shon 202 720-5225

  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.
04/17/2020