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SUPPORTING STATEMENT 

Protection and Advocacy of Individual Rights

INFORMATION COLLECTION 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 copy of the appropriate 

section of each statute and regulation mandating or authorizing the collection of information. 

The Annual Protection and Advocacy of Individual Rights (PAIR) Program Performance 

Report (Form RSA-509) will be used to analyze and evaluate the PAIR Program administered 

by eligible systems in states. These systems provide services to eligible individuals with 

disabilities to protect their legal and human rights. Rehabilitation Services Administration 

(RSA) uses the form to meet specific data collection requirements of Section 509 of the 

Rehabilitation Act of 1973, as amended (the Act), and its implementing federal regulations at 

34 CFR Part 381. PAIR programs must report annually using the form (copy attached), 

which is due on or before December 30 each year. 

The current version of the form is scheduled to expire on June 30, 2014. RSA is requesting 

an extension of the form; there are no changes to the form. 

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. 

Form RSA-509 has enabled RSA to furnish the President and Congress with data on the 

provision of protection and advocacy services and has helped to establish a sound basis for 

future funding requests. Data from the form have been used to evaluate the effectiveness of 

eligible systems within individual states in meeting annual priorities and objectives. These 

data also have been used to indicate trends in the provision of services from year-to-year. 

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 of using information 

technology to reduce burden.

Currently, each PAIR system can transmit the RSA-509 data by e-mail. RSA has also 

developed an electronic management information system (MIS), which allows PAIR systems 

to access and submit data online. 
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4. Describe efforts to identify duplication. Show specifically why any similar information already 

available cannot be used or modified for use of the purposes described in Item 2 above. 

Form RSA-509 provides information on the number of individuals with disabilities currently 

receiving protection and advocacy services authorized by Section 509 of the Act. No similar 

information is available from other data sources. 

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

methods used to minimize burden.

Several respondents are not-for-profit organizations. RSA included the respondents and the 

national organization that represents them in the initial development of this collection of 

information. This was done in an effort to ensure that the information requested could be 

provided with a minimal burden on the respondents

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. 

Because RSA uses the information obtained by this collection in preparing its annual report to 

the President and Congress, current data on protection and advocacy services must be made 

available by eligible systems each year. 

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; 

 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 which unnecessarily impedes sharing of data with other 

agencies for compatible confidential use; or 
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 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 require this information collection to be conducted in 

any manner listed above. 

8. If applicable, provide a copy and identify the date and page number of publication in the Federal 

Register of the agency’s notice, 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.

Form RSA-509 was shared with the National Disability Rights Network (NDRN), formerly

known as the National Association of Protection and Advocacy Systems (NAPAS), an 

organization representing the respondents (State PAIR systems), and the respondents 

themselves. In addition, a 60-day and 30-day notice was published in the Federal Register for 

public comment.

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

contractors or grantees. 

There is no payment or gift to respondents. 

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

assurance in statute, regulation, or agency policy. 

There is no assurance of confidentiality, the collection instrument does not collect 

individual, personal or sensitive data.

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 
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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. 

This report contains no 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, frequency of response, annual hour burden, and an 

explanation of how the burden was estimated. 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. 

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

estimates for each form and aggregate the hour burdens in item. 

 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 16.0

Total hours 912

Cost per hour $33

Total cost $30,096

RSA has estimated the time required for each respondent to complete the form; RSA 

conducted a field test of nine respondents to the Annual PAAT Performance Report during its 

development and found that on average respondents completed the form within 16 hours. 

RSA believes that the form can be completed by PAIR grantees in an equal amount of time. 

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 start-up 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 
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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 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 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. 

States and territories incur no cost burden in addition to that stated in item 12 above. 

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. 

Annual cost to federal government 85 hours x $44/hour $3,740.00

Annual federal computer costs $ 500.00

Total cost to federal government $4,240.00

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

This submission requires no changes to the burden for hours and costs included in current 

OMB inventory; there are no program changes or adjustments. 

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. 
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Reports are due to RSA within 90 days following the end of the fiscal year (approximately 

December 30 of each year). Data reported are evaluated and transmitted to the President and 

Congress in the Annual Report prepared by the Commissioner. 

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. 

We are not seeking approval to not display the expiration date. 

18. Explain each exception to the certification statement identified in "Certification for Paperwork 

Reduction Act Submissions," of new OMB Form 83-I.

There are no exceptions to the certification statement. 

B. Collection of Information Employing Statistical Methods 

This collection of information does not employ any statistical methods.