Certificate Pertaining to Foreign Interests for NTIA Public Wireless Supply Chain Innovation Fund Grant Program

ICR 202505-0660-001CF · OMB 0704-0579 · Active

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0704-0579 can be found here:

2025-05-01 - RCF Recertification

Forms and Documents

Document	Type	Status	Availability
Form 328 Certificate Pertaining to Foreign Interests	Form and Instruction	Modified	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
267393	Certificate Pertaining to Foreign Interests (SF 328)	Form and Instruction	Modified	Certificate Pertaining to Foreign Interests
267393	Certificate Pertaining to Foreign Interests (SF 328)	Other-IT System	Modified

ICR Details

OMB Control No: 0704-0579	ICR Reference No: 202505-0660-001CF
Status: Active	Previous ICR Reference No: 202405-0660-006CF
Agency/Subagency: DOC/NTIA	Agency Tracking No:
Title: Certificate Pertaining to Foreign Interests for NTIA Public Wireless Supply Chain Innovation Fund Grant Program
Type of Information Collection: RCF Recertification	Common Form ICR:
Type of Review Request:
OIRA Conclusion Action: Approved	Conclusion Date: 05/01/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/01/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2027	36 Months From Approved	04/30/2025
Responses	100	0	100
Time Burden (Hours)	167	0	117
Cost Burden (Dollars)	11,680	0	7,120

Abstract:

Authorizing Statute(s): Statute at Large: 134 Stat. 3388 Name of Statute: William M. (Mac) Thornberry National Defense Authorization Act for Fiscal Year 2021
Statute at Large: 136 Stat. 1392 Name of Statute: CHIPS and Science Act of 2022

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Certificate Pertaining to Foreign Interests (SF 328)	328	Certificate Pertaining to Foreign Interests

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	100	100	0
Annual Time Burden (Hours)	167	117	50
Annual Cost Burden (Dollars)	11,680	7,120	4,560

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? No

Agency Contact: Diana Moreno 202 482-1034 [email protected]

Common Form ICR: