Federal Write-In Absentee Ballot (FWAB)

Forms and Documents

Document Name	Status
Form SF 186 FWAB Form and Instruction	Modified
FWAB_60Day_20170309.pdf Supplementary Document	2017-09-11
Report on the Re-Design of the FWAB Form.pdf Supplementary Document	2017-09-11
Illustration of Changes to FWAB Form.pdf Supplementary Document	2017-09-11
FWAB_SF186_SSN Approval_Other Cases_20170405.pdf Supplementary Document	2017-08-04
SupportingStatement_FWAB_0704-0502_20170912.docx Supporting Statement A	2017-09-13

IC Document Collections

IC ID	Document Title	Status
207366	FWAB Form and Instruction	Modified

ICR Details

OMB Control No: 0704-0502	ICR Reference No: 201708-0704-001
Status: Historical Active	Previous ICR Reference No: 201504-0704-001
Agency/Subagency: DOD/DODDEP	Agency Tracking No: 0704-0502
Title: Federal Write-In Absentee Ballot (FWAB)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/13/2017
	Date Received in OIRA: 08/09/2017
Terms of Clearance: This collection is approved based on the revised materials provided by the Department.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2020	36 Months From Approved	05/31/2018
Responses	1,200,000	0	1,200,000
Time Burden (Hours)	300,000	0	300,000
Cost Burden (Dollars)	6,756,000	0	6,381,000

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Abstract: The Uniformed and Overseas Citizens Absentee Voting Act(UOCAVA),42 USC 1973ff, requires the Presidential designee (SECDEF) to prescribe the Federal write-in absentee ballot for absent uniformed service voters and overseas voters in general elections for Federal office. The form serves as a backup ballot for voters who did not receive their State ballot with enough time to vote and return it to their local election official. The authority for the States to collect personal information comes from UOCAVA.

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Authorizing Statute(s): US Code: 52 USC 203 Name of Law: The Uniformed and Overseas Citizens Absentee Voting Act
  

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:
	82 FR 12948	03/08/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 36385	08/04/2017
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
FWAB	SF 186	Federal Write-In Absentee Ballot

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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	1,200,000	1,200,000	0	0	0	0
Annual Time Burden (Hours)	300,000	300,000	0	0	0	0
Annual Cost Burden (Dollars)	6,756,000	6,381,000	0	0	375,000	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:

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Annual Cost to Federal Government: $64,000

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

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.     Yes

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.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 08/09/2017

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