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ICRAS ICR ID and OMB Number: (XXXX) 1880-NEW

Revised: 09/16/2014

RIN Number: XXXX-XXXX (if applicable)

SUPPORTING STATEMENT

FOR PAPERWORK REDUCTION ACT SUBMISSION

ICRAS ICR ID and OMB Number: (XXXX) 1880-NEW

Revised XX/XX/XXXX

RIN Number: XXXX-XXXX (if applicable)

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 section. Please limit pasted text to no longer than 3 pages. 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.

The collection is necessary to certify the identity of individuals requesting information 

under the Freedom of Information Act (FOIA) and Privacy Act (PA). This certification 

is required under 5 U.S.C. Section 552a(b).

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.

The form is used by Privacy Act requestors to obtain personal records via regular mail, 

fax or email. The department will use the information to help identify first-party 

requesters with same or similar name when requesting retrieval of their own documents. 

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.

Use of an electronic signature is acceptable. This form may be filled out and filed 

electronically. This will minimize instances of misinformation and reduce the usage of 

paper forms to collect necessary information.
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ICRAS ICR ID and OMB Number: (XXXX) 1880-NEW

Revised: 09/16/2014

RIN Number: XXXX-XXXX (if applicable)

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 

Question 2 above.

The files are checked to ensure that a Certificate of Identity is on file. Electronic 

submission will eliminate the receipt of duplicate copies. There is no similar information 

collection activity already in use.

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.

This collection of information has no significant impact on small businesses.

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.

If the collection activity is not conducted, the request for personal records would not be 

granted. It would jeopardize the protection of personal information and nor meet the 

requirements of 5 U.S.C. Section 552a(b).

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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ICRAS ICR ID and OMB Number: (XXXX) 1880-NEW

Revised: 09/16/2014

RIN Number: XXXX-XXXX (if applicable)

 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 associated with this collection. 

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-day and 30-day notice was published in the Federal Register in order to solicit 

comments from the public. No comments were received.

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

remuneration of contractors or grantees with meaningful justification.

No payment or gift is associated with this information collection.

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 
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ICRAS ICR ID and OMB Number: (XXXX) 1880-NEW

Revised: 09/16/2014

RIN Number: XXXX-XXXX (if applicable)

Assessment was completed as indicated on the ICRAS’ Part 2 IC form. A confidentiality

statement with a legal citation that authorizes the pledge of confidentiality should be 

provided. 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). If 

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 certifications are maintained by the FOIA offices that provide the individual with the 

requested information pursuant to 5 U.S.C. Section 552. While no particular statements 

offering assurances of confidentiality are provided to the individual on the certification 

form, the FOIA office does comply with PII procedures.

A Privacy Act Statement is included on the form. The text of the statement follows:

In accordance with 34 CFR Section 5b.5(b)(2) personal data sufficient to identify the individuals 

submitting requests by mail under the Privacy Act of 1974, 5 U.S.C. Section 552a, is required. 

The purpose of this solicitation is to ensure that the records of individuals who are the subject of 

U.S. Department of Education systems of records are not wrongfully disclosed by the 

Department. Requests will not be processed if this information is not furnished. False information 

on this form may subject the requester to criminal penalties under 18 U.S.C. Section 1001 and/or 

5 U.S.C. Section 552a(i)(3).

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.

No records of a sensitive nature are maintained.

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 Question 12. Unless 

directed to do so, agencies should not conduct special surveys to obtain information 
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ICRAS ICR ID and OMB Number: (XXXX) 1880-NEW

Revised: 09/16/2014

RIN Number: XXXX-XXXX (if applicable)

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. (The table should at minimum include Respondent types, 

Number of Respondents 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 

Question 14.

It is estimated that 62,000 individuals will submit the form and the form takes about 30 

minutes to complete and submit, totaling 31,000 hours. 

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 Questions 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 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 

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 
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ICRAS ICR ID and OMB Number: (XXXX) 1880-NEW

Revised: 09/16/2014

RIN Number: XXXX-XXXX (if applicable)

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

Question 12.

Total Annualized Capital/Startup Cost:

Total Annual Costs (O&M): 

Total Annualized Costs Requested:

There is no new cost or annual cost associated with this collection.

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 Questions 12, 13, and 14 

in a single table.

There are no costs to the Federal Government.

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 

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).

This is a new collection, therefore all burden is new. This results in a program change 

increase in burden and responses of 62,000 responses and 31,000 hours respectively.

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. 

The results of this information collection will not be published.
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ICRAS ICR ID and OMB Number: (XXXX) 1880-NEW

Revised: 09/16/2014

RIN Number: XXXX-XXXX (if applicable)

17. 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 results will not be published.

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

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

ED is not seeking this approval.

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

Paperwork Reduction Act.

There are no exceptions to the Certification Statement.