1

OMB Number: 1855
- 0122
**SUPPORTING STATEMENT**

**FOR PAPERWORK REDUCTION ACT SUBMISSION** 

**OMB Number: 1855**  **- 0012**  **Revised 02/**  **2 6**  **/2014** 

### 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 auth orizing 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.** An application is required to award the State Charter School Facilities Incentive Grants Program. These grants are made to States to provide them with an incentive to create new or enhance existing per
-pupil facilities aid programs for charter schools. These grants are authorized by Title V, Part B, Subpart 2 of the Elementary and Secondary

Education Act as amended by the No Child Left Behind Act of 2001. The U.S. Department of E ducation is seeking approval for an electronic collection for the applicati on for the State Charter School Facilities Incentive Grants Program
. **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 application allows States to apply for Federal assistance. The applicants will provide a description of their proposed activities and provide information necessary to determine which grant applications should be funded. An additio nal part of the application consists of assurances regarding the applicant's compliance with applicable Federal laws and regulations. The information provided in the application will allow field readers and the Department of Education to determine if applicants are eligible and identify which applications most merit funding.2

OMB Number: 1855
- 0122 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.**  Applicants will be required to su bmit a mandatory Grants.gov application to the U.S. Department of Education. We will insert the most recent Grants.gov language in the application package shortly prior to announcing any

future grant competition. We are not including the Grants.gov now b ecause it frequently changes. **4. Describe ef** 

**forts 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 information supplied by the a pplicant is not in any

other data collection, and is unique to this program and the particular grantee. The application is a single document intended to serve a specific authorized purpose, and is in keeping with statutory requirements. **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 fi**  **eld 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, sch ool district, or special district with a population of less**  **than 50,000.** Small businesses are not impacted b y this data collection. **6. Describe the consequences to Federal program or policy activities if the collection is**  **not conducted or is conducted less f requently, as well as any technical or legal**  **obstacles to reducing burden.** The Department cannot distribute these grant awards to recipients without an application requesting the funds. The Department would not know which organizations want or merit funding if this information was not collected. **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;**3

OMB Number: 1855
- 0122

 **requiring respondents to submit more than an original and two copies of any document;** 
 **requiring respondents to retain records, other than health, medica l, 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 sta tistical 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 t hat 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 circum stances that require the collection to be conducted in a manner inconsistent with the guidelines in 5 CFR 1320.5. **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 comm**  **ents 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 b urden.**  **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 s ame as in prior periods. There may be**  **circumstances that may preclude consultation in a specific situation. These circumstances should be explained.**  The Department has consulted with potential applicants, other interested organizations and entities to ob tain their views on the availability of possible requested information and potential application processes for these grants. This is a discretionary

grant data collection; the Department published a 30
- day Federal Register notice s eeking public comment
.4

OMB Number: 1855
- 0122 **9. Explain any decision to provide any payment or gift to respondents, other than**  **remuneration of contractors or grantees with meaningful justification**  **.** No gifts or pay

ments will be made to application respondents other than the award to the grant recipient
. **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**  **th e instrument. Please provide a citation for the Systems of Record Notice and the**  **date a Privacy Impact Assessment was completed as indicated on the ICRAS’ Part 2**  **IC form . A confidentiality statement with a legal citation that authorizes the**  **pledge of**  **confi dentiality**  **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**

**– F**  **ederal 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 make**  **s no pledge about the confidentially of the data.**  No assurance of confidentiality is provided. **11. Provide additional justification for any questions of a sensitive nature, such as**  **sexual behavior and atti tudes, 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 t o persons from whom the information is**  **requested, and any steps to be taken to obtain their consent.** There is no question of sensitive nature in this collection of information. **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 govern**  **ments), 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 dir**  **ected 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**5

OMB Number: 1855
- 0122

**on respondents is expected to v ary 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 Respondent**  **s and Responses, Hours/Response, and**  **Total Hours)**
 **Provide estimates of annual ized 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.** Estimated respondent cost for an application is based on 40 hours per application. The figure of 40 hours is based on our own experience and the comments the eligible applicants that we consulted. We estimate respondent cost at an average of $25 per hour so that the average cost per application would be $25 x 40 hours = $1000. We expect that a total of 12 applications will be received from eligible applicants. Total estimated cost: $ 1 000 x 12 applications = $12 ,000. Estimated data burden for grants: Annual reporting burden per response (preparing and submitting application): 40 hours x 12 applicants = 480 hours Total Burden for Grant = 4 8 0 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**  **Question s 12 and 14.)** 
 **The cost estimate should be split into two compon ents: (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, mainta ining, 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 rec**  **ord 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** 6

OMB Number: 1855
- 0122

**out information collection services should be a part of this cost burde n 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 ru**  **lemaking 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**  **Question 12**  **. Total Annualized Capital/Startup Cost:**  **Total Annual Costs (O&M): Total Annualized Costs Requested:**  There are no startup costs to respondents. **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.** Estimated annualized Federal cost: $3321.60 Program Personnel: 1 person @ $ 41.07/hr. x 80 hours : $ 3285.60 Printing applications : 12 applications x 3 copies per application: $ 36.00 **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 s ize 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 res pondent 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,** 7

OMB Number: 1855
- 0122 **revision, extension, reinstatement with change , reinstatement without change) and**  **include totals for**  **changes in burden hours , responses**  **and cost s**  **(if applicable) .**  This data collection is being reinstated to award grants under the State Charter School Facilities Incentive Grants Program; there is a pro gram change increase of 480 annual hours. **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.**  There is no plan for publication. **17. Provi**  **de 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. If seeking approval to not display the expiration date for OMB approval of the**  **information collection, explain the reasons that display would be inappropriate.** The expiration date will be displayed on the information collection. **18. Explain each exception to the certification statement identified in the Certification**  **of Paperwork Reduct ion Act.**  Items F & I are were not applicable on the Certification for Paperwork Reduction Act Submission.