Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Programs

Forms and Documents

Document Name	Status
Form SSA-96 BK Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Program Form	New
Supporting Statement 0184.doc Supporting Statement A	2009-06-09
Addendum to the Supporting Statement SSA.doc Supplementary Document	2009-06-16
FW OMB comments on 0960-0184--SSA-96.htm Supplementary Document	2006-08-11

IC Document Collections

IC ID	Document Title	Status
43699	Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Programs Other-Electronic Form	Modified
189136	Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Program Form	New

ICR Details

OMB Control No: 0960-0184	ICR Reference No: 200905-0960-004
Status: Historical Active	Previous ICR Reference No: 200606-0960-015
Agency/Subagency: SSA	Agency Tracking No:
Title: Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Programs
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/10/2009
	Date Received in OIRA: 06/16/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2012	36 Months From Approved	11/30/2009
Responses	800	0	800
Time Burden (Hours)	11,200	0	11,200
Cost Burden (Dollars)	0	0	0

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Abstract: SSA uses information from Form SSA-96-BK in selecting grant proposals for funding based on their technical merits. This information assists the agency in evaluating the soundness of the design of proposed activities, the possibilities of obtaining productive results, the adequacy of resources to conduct the activities, and the relationship to other similar activities of the respondents. The respondents are State and local governments, State-designated protection and advocacy groups, colleges, universities, profit and nonprofit private organizations.

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Authorizing Statute(s): US Code: 42 USC 1310 Name of Law: Cooperative research or demonstration projects
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 15808	04/07/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 27379	06/09/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Programs
Instructions for Completion of Federal Assistance Application for SSA Research and Demonstration Grant Program	SSA-96 BK	Instructions for Completing of Federal Assistance Application for SSA Research and Demonstration Grant Programs

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ICR Summary of Burden

	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	800	800	0	0	0	0
Annual Time Burden (Hours)	11,200	11,200	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: There is no change in burden. Prior to ROCIS we could not show the breakdown between respondents' electronic and paper form submissions.

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Annual Cost to Federal Government: $80,000

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 06/16/2009

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