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OMB Number: 1820-0625 Revised: 9/10/2014

SUPPORTING STATEMENT

FOR PAPERWORK REDUCTION ACT SUBMISSION

A. Justification 

1. Explain the circumstances that make the collection of information necessary. Identify 

any legal or administrative requirements that necessitate the collection. Attach a hard 

copy of the appropriate section of each statute and regulation mandating or authorizing the 

collection of information, or you may provide a valid URL link or paste the applicable 

section1. Specify the review type of the collection (new, revision, extension, reinstatement 

with change, reinstatement without change). If revised, briefly specify the changes. If a 

rulemaking is involved, make note of the sections or changed sections, if applicable.

Section 509 of the Rehabilitation Act of 1973, as amended (Rehabilitation Act), established 

the Protection and Advocacy of Individual Rights (PAIR) program to support the protection 

and advocacy (P&A) system in each State. The P&A system was created by the 

Developmental Disabilities Assistance and Bill of Rights Act of 2000 (DD Act) (42 USC 

6041 et seq.) to protect the legal and human rights of individuals with disabilities. 

Prior to the 1992 amendments to the Rehabilitation Act, the P&A system was required to 

operate two programs: the Protection and Advocacy for the Developmentally Disabled 

(PADD) program and the Protection and Advocacy for Individuals with Mental Illness 

(PAIMI) program. Unfortunately, these programs were unable to meet the needs of many 

people with disabilities due to narrowly defined eligibility requirements. Congress funded 

the PAIR program with the 1992 amendments so that the PAIR program could advocate for 

those individuals with disabilities who were ineligible for advocacy services from the PADD 

and PAIMI programs. PAIR also is authorized to serve those individuals with disabilities 

whose issues fall beyond the scope of services that the Client Assistance Program (CAP) can 

provide. 

PAIR, which is a required component of the P&A system in each State, is administered by 

the Rehabilitation Services Administration (RSA) pursuant to the requirements of Section 

509 of the Rehabilitation Act. Section 509(f) of the Rehabilitation Act sets forth the 

application requirements for the PAIR program. Most of these requirements mirror the 

requirements set forth in Part C of the DD act. One of the application requirements is that 

the PAIR program sign a set of assurances that the PAIR can and will carry out its statutorily

prescribed purposes and functions. This preprint, which is being submitted for approval, 

contains the assurances to which the PAIR program must agree. These assurances are based 

on the following statutory and regulatory requirements: 

 

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OMB Number: 1820-0625 Revised: 9/10/2014

1) Title V, Section 509, of the Rehabilitation Act; 

2) Federal regulations at 34 CFR Part 381 implementing section 509 of the 

Rehabilitation Act; 

3) Part C of the DD Act, which sets forth all of the requirements for the P&A system; 

and 

4) General requirements for all written requests for assistance under the Education 

Department General Administrative Regulations (34 CFR Part 76). 

2. Indicate how, by whom, and for what purpose the information is to be used. Except for 

a new collection, indicate the actual use the agency has made of the information received 

from the current collection.

A signed set of assurances is a condition for receipt of Federal funds for the PAIR program. 

This requirement is mandated specifically for the PAIR program by section 509 of the 

Rehabilitation Act and its implementing regulations at 34 CFR Part 381 and for the P&A 

system in general by the DD Act and its implementing regulations. The assurances list all 

of the requirements that must be satisfied in order for the program to receive Federal funds 

under section 509 of the Rehabilitation Act. 

RSA required each P&A to submit the assurances and other materials only once, prior to 

fiscal year (FY) 2007, beginning October 1, 2006. These materials served as a request for 

FY 2007 funds, and for funding in all subsequent fiscal years, until such time as the 

Governor, in accordance with the provisions of the DD Act, may redesignate the P&A. 

This procedure reduces the reporting burden on the P&As and simplifies the process by 

which grant awards are made by RSA.

This preprint, which is being submitted for approval, is without revisions from the previous 

preprint approved by OMB under number 1820-0625. This version of the PAIR assurances 

will expire on October 31, 2014. 

3. Describe whether, and to what extent, the collection of information involves the use of

automated, electronic, mechanical, or other technological collection techniques or forms of 

information technology, e.g. permitting electronic submission of responses, and the basis 

for the decision of adopting this means of collection. Also describe any consideration given 

to using technology to reduce burden.

This is a preprinted legal document, which requires authoritative signature and minimal 

reporting burden. PAIR programs are not allowed to submit an electronic version of this 

document because it requires an authoritative signature. The possibility of allowing the 

grantees to submit the form electronically, with a hard copy of the signature page, was 

considered. However, the assurances preprint consists of only a two-page document in 

which the grantee is only required to check each of the 10 boxes to assure compliance and 

sign the form. RSA deliberately made this preprint simple so that little effort is required on 

the part of the PAIR grantee. The burden on the grantee is so minimal that it does not justify

allowing the grantee to submit the PAIR Assurances in two stages. 
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OMB Number: 1820-0625 Revised: 9/10/2014

4. Describe efforts to identify duplication. Show specifically why any similar information 

already available cannot be used or modified for use for the purposes described in Item 2 

above.

This document collects unique information that is not collected under any other instrument. 

Information collected by this set of assurances is required by Federal Statute and is not 

obtained through any other data source. 

5. If the collection of information impacts small businesses or other small entities, describe 

any methods used to minimize burden. A small entity may be (1) a small business which is 

deemed to be one that is independently owned and operated and that is not dominant in its 

field of operation; (2) a small organization that is any not-for-profit enterprise that is 

independently owned and operated and is not dominant in its field; or (3) a small 

government jurisdiction, which is a government of a city, county, town, township, school 

district, or special district with a population of less than 50,000.

The collection of this information does not involve small businesses or other small entities. 

6. Describe the consequences to Federal program or policy activities if the collection is not 

conducted or is conducted less frequently, as well as any technical or legal obstacles to 

reducing burden.

As described above in answer to number two (2), the Federal regulations require the PAIR 

program to submit the application and signed assurances and other materials only once prior 

to October 1, 2006. These materials served as the request for FY 2007 funds and all 

subsequent fiscal years, until such time as the PAIR program in the State may be redesignated. 

7. Explain any special circumstances that would cause an information collection to be 

conducted in a manner:

 requiring respondents to report information to the agency more often than 

quarterly;

 requiring respondents to prepare a written response to a collection of information in 

fewer than 30 days after receipt of it;

 requiring respondents to submit more than an original and two copies of any 

document;

 requiring respondents to retain records, other than health, medical, government 

contract, grant-in-aid, or tax records for more than three years;

 in connection with a statistical survey, that is not designed to produce valid and 

reliable results than can be generalized to the universe of study;
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OMB Number: 1820-0625 Revised: 9/10/2014

 requiring the use of a statistical data classification that has not been reviewed and 

approved by OMB;

 that includes a pledge of confidentiality that is not supported by authority 

established in statute or regulation, that is not supported by disclosure and data 

security policies that are consistent with the pledge, or that unnecessarily impedes 

sharing of data with other agencies for compatible confidential use; or

 requiring respondents to submit proprietary trade secrets, or other confidential 

information unless the agency can demonstrate that it has instituted procedures to 

protect the information’s confidentiality to the extent permitted by law.

There are no special circumstances that would require this information to be collected in 

a different manner.

8. As applicable, state that the Department has published the 60 and 30 Federal Register 

notices as required by 5 CFR 1320.8(d), soliciting comments on the information 

collection prior to submission to OMB. Summarize public comments received in 

response to that notice and describe actions taken by the agency in response to these 

comments. Specifically address comments received on cost and hour burden.

Describe efforts to consult with persons outside the agency to obtain their views on the 

availability of data, frequency of collection, the clarity of instruction and record 

keeping, disclosure, or reporting format (if any), and on the data elements to be 

recorded, disclosed, or reported.

Consultation with representatives of those from whom information is to be obtained or 

those who must compile records should occur at least once every 3 years – even if the 

collection of information activity is the same as in prior periods. There may be 

circumstances that may preclude consultation in a specific situation. These 

circumstances should be explained.

A 60-and 30-day Federal Register Notice was published, receiving no public comments 

during the 60-day comment period. Consultation was sought from the PAIR grantees and the 

National Disability Rights Network (NDRN), formerly known as the National Association of 

Protection and Advocacy Systems (NAPAS). Furthermore, the PAIR grantees and NDRN 

had opportunities to comment on the statutory requirements governing the PAIR program 

during the most recent reauthorization process for the Rehabilitation Act. 

9. Explain any decision to provide any payment or gift to respondents, other than 

remuneration of contractors or grantees with meaningful justification.

There is no payment or gift to respondents. 
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OMB Number: 1820-0625 Revised: 9/10/2014

10. Describe any assurance of confidentiality provided to respondents and the basis for the 

assurance in statute, regulation, or agency policy. If personally identifiable information 

(PII) is being collected, a Privacy Act statement should be included on the instrument. 

Please provide a citation for the Systems of Record Notice and the date a Privacy Impact 

Assessment was completed as indicated on the IC Data Form. A confidentiality statement 

with a legal citation that authorizes the pledge of confidentiality should be provided.2If the 

collection is subject to the Privacy Act, the Privacy Act statement is deemed sufficient with 

respect to confidentiality. If there is no expectation of confidentiality, simply state that the 

Department makes no pledge about the confidentially of the data.

The written request does not contain specific or personal information; there are no 

assurances of confidentiality. 

11. Provide additional justification for any questions of a sensitive nature, such as sexual 

behavior and attitudes, religious beliefs, and other matters that are commonly considered 

private. The justification should include the reasons why the agency considers the 

questions necessary, the specific uses to be made of the information, the explanation to be 

given to persons from whom the information is requested, and any steps to be taken to 

obtain their consent.

The written request does not contain any questions of a sensitive nature.

12. Provide estimates of the hour burden of the collection of information. The statement 

should:

 Indicate the number of respondents by affected public type (federal government, 

individuals or households, private sector – businesses or other for-profit, private 

sector – not-for-profit institutions, farms, state, local or tribal governments), 

frequency of response, annual hour burden, and an explanation of how the 

burden was estimated, including identification of burden type: recordkeeping, 

reporting or third party disclosure. All narrative should be included in item 12. 

Unless directed to do so, agencies should not conduct special surveys to obtain 

information on which to base hour burden estimates. Consultation with a 

sample (fewer than 10) of potential respondents is desirable. If the hour burden 

on respondents is expected to vary widely because of differences in activity, size, 

or complexity, show the range of estimated hour burden, and explain the reasons 

for the variance. Generally, estimates should not include burden hours for 

customary and usual business practices.

 

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Requests for this information are in accordance with the following ED and OMB policies: Privacy Act of 1974, 

OMB Circular A-108 – Privacy Act Implementation – Guidelines and Responsibilities, OMB Circular A-130 

Appendix I – Federal Agency Responsibilities for Maintaining Records About Individuals, OMB M-03-22 – OMB 

Guidance for Implementing the Privacy Provisions of the E-Government Act of 2002, OMB M-06-15 –

Safeguarding Personally Identifiable Information, OM:6-104 – Privacy Act of 1974 (Collection, Use and Protection 

of Personally Identifiable Information)
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OMB Number: 1820-0625 Revised: 9/10/2014

 If this request for approval covers more than one form, provide separate hour 

burden estimates for each form and aggregate the hour burdens in the ROCIS 

IC Burden Analysis Table. (The table should at minimum include Respondent 

types, IC activity, Respondent and Responses, Hours/Response, and Total 

Hours)

 Provide estimates of annualized cost to respondents of the hour burdens for 

collections of information, identifying and using appropriate wage rate 

categories. The cost of contracting out or paying outside parties for information 

collection activities should not be included here. Instead, this cost should be 

included in Item 14.

Annual Burden

Number of respondents 57

Frequency of response 1

Total annual responses 57

Hours per response 0.16*

Total hours 9.1

Cost per hour $20

Total cost $182.00

* The burden hours associated with the written request for a PAIR program grant is

estimated at 10 minutes, or .16 hours, per P&A in each State or territory. The estimated 

hour burden per P&A is not expected to vary significantly. Estimated burden hours are 

founded on judgments based on submittals of similar written requests for P&A grants 

administered by RSA, including the PAAT program and CAP.

13. Provide an estimate of the total annual cost burden to respondents or record keepers 

resulting from the collection of information. (Do not include the cost of any hour burden 

shown in Items 12 and 14.)

 The cost estimate should be split into two components: (a) a total capital and startup cost component (annualized over its expected useful life); and (b) a total 

operation and maintenance and purchase of services component. The estimates 

should take into account costs associated with generating, maintaining, and 

disclosing or providing the information. Include descriptions of methods used to 

estimate major cost factors including system and technology acquisition, expected 

useful life of capital equipment, the discount rate(s), and the time period over which 

costs will be incurred. Capital and start-up costs include, among other items, 

preparations for collecting information such as purchasing computers and software; 

monitoring, sampling, drilling and testing equipment; and acquiring and 

maintaining record storage facilities.

 If cost estimates are expected to vary widely, agencies should present ranges of cost 

burdens and explain the reasons for the variance. The cost of contracting out 
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information collection services should be a part of this cost burden estimate. In 

developing cost burden estimates, agencies may consult with a sample of 

respondents (fewer than 10), utilize the 60-day pre-OMB submission public 

comment process and use existing economic or regulatory impact analysis associated 

with the rulemaking containing the information collection, as appropriate.

 Generally, estimates should not include purchases of equipment or services, or 

portions thereof, made: (1) prior to October 1, 1995, (2) to achieve regulatory 

compliance with requirements not associated with the information collection, (3) for 

reasons other than to provide information or keep records for the government or (4) 

as part of customary and usual business or private practices. Also, these estimates 

should not include the hourly costs (i.e., the monetization of the hours) captured 

above in Item 12

Total Annualized Capital/Startup Cost: N/A

Total Annual Costs (O&M): N/A

____________________

Total Annualized Costs Requested: N/A

There is no additional cost burden to the P&As in each State and territory when 

submitting the written assurances for a PAAT grant.

14. Provide estimates of annualized cost to the Federal government. Also, provide a 

description of the method used to estimate cost, which should include quantification of 

hours, operational expenses (such as equipment, overhead, printing, and support staff), 

and any other expense that would not have been incurred without this collection of 

information. Agencies also may aggregate cost estimates from Items 12, 13, and 14 in a 

single table.

a. Review of each written request .16 hours

b. Number of written requests to review 57

c. Total time to review written requests 9.1 hours*

d. Federal hourly rate of salary $49

e. Total cost (c x d) $446

* The estimated burden hours to the federal government does not include time 

needed for negotiations when a written request is not approvable. Given the 

perfunctory nature of this written request, it would be unusual for a request to not 

be approvable.

15. Explain the reasons for any program changes or adjustments. Generally, adjustments 

in burden result from re-estimating burden and/or from economic phenomenon outside of 

an agency’s control (e.g., correcting a burden estimate or an organic increase in the size of 

the reporting universe). Program changes result from a deliberate action that materially 
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changes a collection of information and generally are result of new statute or an agency 

action (e.g., changing a form, revising regulations, redefining the respondent universe, etc.). 

Burden changes should be disaggregated by type of change (i.e., adjustment, program 

change due to new statute, and/or program change due to agency discretion), type of 

collection (new, revision, extension, reinstatement with change, reinstatement without 

change) and include totals for changes in burden hours, responses and costs (if applicable).

There are no program changes or adjustments; this submission requires no changes to the 

burden for hours and costs included in current OMB inventory. With the exception of 

updating the hourly wage for Federal employees based on current information. 

16. For collections of information whose results will be published, outline plans for 

tabulation and publication. Address any complex analytical techniques that will be used. 

Provide the time schedule for the entire project, including beginning and ending dates of 

the collection of information, completion of report, publication dates, and other actions.

The information collected will not be published for statistical use.

17. If seeking approval to not display the expiration date for OMB approval of the 

information collection, explain the reasons that display would be inappropriate.

This document is not seeking OMB approval not to display the expiration date.

18. Explain each exception to the certification statement identified in the Certification of 

Paperwork Reduction Act.

There are no exceptions to the certification statement.

B. Collection of Information Employing Statistical Methods

The written request for a PAIR grant is a legal document and does not require the use of any

statistical methods in obtaining information.