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EDICS Tracking and OMB Number: (XXXX) 1820
- 0658 Revised: 05/01 /2013

**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 section**  **1 . Specify the review type of the collectio**  **n (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.**  Public L aw 108
- 364, Section 5, of the Assistive Technology Act of 1998 , as amended in 2004 ( AT Act), requires that the secretary make a grant to an entity in each state to support protection and advocacy (P&A) services through the sy stems established to provide P&A services under the Develo pmental Disabilities Assistance and Bill of Rights Act of 2000 (

DD Act), (42 USC 6041 et seq.), for the purposes of assisting in the acquisition, utilization or maintenance of assistive technology or assistive technology services for individuals with disab ilities. The P&A s ys tem was created by the DD Act to protect the legal and human rights of individuals with disabilities. Effective as of February

2, 2004, the administration of the Protection and Advocacy for Assistive Technology

(PAAT) program was transferred from the National Institute on Disability and Rehabilitation Research to the Rehabilitation Services Administration (RSA). To apply for PAAT program funds, grantees must sign and submit to RSA a set of assurances that they

can and will carry

out their statutorily

prescribed purposes and functions under the PAAT program. This preprint, which is being submitted for approval, contains the assurances to which the PAAT program grantees must agree. These assurances are based on the following statuto ry and regulatory

requirements: (1) Section 5 of the AT Act ; and (2) General requirements for all written requests for funding, pursuant to the Education Department General Administrative Regulations ( EDGAR ) (34 CFR Part 76).

1 Please limit pasted text to no longer than 3 paragraphs.2

EDICS Tracking and OMB Number: (XXXX) 1820
- 0658 Revised: 05/01 /2013

**2. In dicate 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.**  Although Section 5 of the AT Act does not contain any provisions specifying the manner by which an application for PAAT funding must be made, an approved written request is a condition for receipt of federal funds under EDGAR , 34 CFR Part 76. RSA has developed the materials listed below to serve as the request for funds under the PAAT program. The materials are similar to those used by the P&A s ys tems in each state to request funding under other P&A programs administered b y RSA, including those for the Protection and Advocacy of Individual Rights (PAIR) program and the Client Assistance Program (CAP). 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 ye ars, 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 b y which grant awards are m ade b y RSA. This preprint, which is being submitted for approval, is without revisions from the previous preprint approved by OMB under number 1820

- 0658. This version of the PAAT ass urances will expire on October 31, 2013
. **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 de cision 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 an authoritative signature and minimal reporting burden. P&As do not submit re sponses electronicall y because an authoritative signature is required. The possibility of submitting responses electronically , with just a hard cop y signature page, was considered. However, because the reporting burden is so minimal and the form is so sh ort, it did not justify allowing the submission to be done in two stages. **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. The written request is required by federal regulation and is not obtained through any other data source.3

EDICS Tracking and OMB Number: (XXXX) 1820
- 0658 Revised: 05/01 /2013
**5. If the collection of information impacts s mall 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 s mall 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.**  The provisions of EDGAR require grantees to submit a written application or request for formula grant funds, such as those available under the PAAT program, though there is no requirement regarding the frequency of the submission. As described above in response to item number 2, the assurances and other materials were submitted onl y once prior to the budget period beginning October 1, 2006. These materials served as the request for FY 2007 funds and all subsequent fiscal ye ars, until such time as the P&A in the state may be redesignated. If the P&A fails to complete the application as required, the P&A will not be eligible for federal funds for the PAAT program. This method has been established as the required procedure. **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;** 4

EDICS Tracking and OMB Number: (XXXX) 1820
- 0658 Revised: 05/01 /2013

 **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 informat** **ion 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 respons**  **e 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 i**  **s 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.**  The assurances are taken directly from federal law and regulations. RSA will seek public comments through Federal Register notices. **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 pay

ment or gift to respondents. **10. Describe any assurance of confidentiality provided to respondents and the basis for the assurance in statute, regulation, or age**  **ncy 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**5

EDICS Tracking and OMB Number: (XXXX) 1820
- 0658 Revised: 05/01 /2013 **with a legal citation that authorizes the pledge**  **of confidentiality**  **should be provided. 2**  **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 make s**  **no pledge about the confidentially of the data.** The written request does not contain specific or personal information. **11. Provide additional just ification 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 necess ary, 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 natur e. **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**  **- profi**  **t, 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 potent ial 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 sh ould 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 the**  **ROCIS IC Burden Analysis Table.**  **( The table should at**  **minimum include Respondent**  **types, IC activity, Respondent and Responses, Hours/Response, and Total Hours)** 

2 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 Re sponsibilities 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)6

EDICS Tracking and OMB Number: (XXXX) 1820
- 0658 Revised: 05/01 /2013

 **Provide estimates of annualized cost to respondents of the hour burdens for collections of information, identifying and using ap**  **propriate 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 Frequen cy

of response 1 Total annual responses 57 Hours per response 0.16* Total hours 9 Cost per hour $20 Total cost $180.00 * The burden hours associated with the written request for a PAAT 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 b y RSA, including the PAIR 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 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 associate d 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 acqu iring 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**7

EDICS Tracking and OMB Number: (XXXX) 1820
- 0658 Revised: 05/01 /2013 **respondents (fewer than 10), utilize the 60 -**  **day pre -**  **OMB submission public comment process and use existing economic or regulatory impact analy**  **sis 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**  **compli ance 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 no**  **t 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

____________________ T otal 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 re quest .16 hours b. Number of written requests to review 57 c. Total time to review written requests 9 hours* d. Federal hourl y rate of salary $43 e. Total cost (c x d) $387
* The estimated burden hours to the federal government doe s 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 adjus tments. Generally, adjustments**  **in burden result from re -**  **estimating burden and/or from economic phenomenon outside of**8

EDICS Tracking and OMB Number: (XXXX) 1820
- 0658 Revised: 05/01 /2013 **an agency’s control (e.g., correcting a burden estimate or an organic increase in the size of the reporting universe). Program changes resu**  **lt 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 di**  **saggregated 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 f or**  **changes in burden hours , responses**  **and cost s**  **(if applicable) .**  This submission requires no changes to the burden for hours and costs included in current OMB inventory
. **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 I**  **nformation Employing Statistical Methods**  The written request for a PAAT grant is a legal document and does not require the use of any statistical methods in obtaining information.