[Federal Register Volume 77, Number 60 (Wednesday, March 28, 2012)]
[Notices]
[Pages 18850-18851]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-7412]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF THE INTERIOR

Office of the Secretary


Notice of Proposed Renewal of Information Collection: Donor 
Certification Form

AGENCY: Office of Youth, Partnerships and Service, Assistant 
Secretary--Policy, Management and Budget, Interior.

ACTION: Notice and Request for Comments.

-----------------------------------------------------------------------

SUMMARY: In compliance with section 3506(c)(2)(A) of the Paperwork 
Reduction Act of 1995, the Office of Youth, Partnerships and Service 
seeks public comments on the renewal of the information collection 
associated with the Interior Department Donor Certification Form.

DATES: Consideration will be given to all comments received by May 29, 
2012.

ADDRESSES: Written comments and recommendations on the information 
collection should be sent to Olivia Barton Ferriter, Office of Youth, 
Partnerships and Service, 1849 C St. NW., MS 3559 MIB, Washington, DC 
20240, or email her at <a href="/cdn-cgi/l/email-protection#90dffcf9e6f9f1cfd6f5e2e2f9e4f5e2d0f9ffe3bef4fff9bef7ffe6"><span class="__cf_email__" data-cfemail="eba487829d828ab4ad8e9999829f8e99ab828498c58f8482c58c849d">[email protected]</span></a>. Individuals 
providing comments should reference Donor Certification Form.

FOR FURTHER INFORMATION CONTACT: To request more information on this 
information collection or to obtain a copy of the associated collection 
instrument, please write to the above address, or call Olivia Barton 
Ferriter on 202-208-4881.

SUPPLEMENTARY INFORMATION: 

I. Abstract

    Office of Management and Budget (OMB) regulations at 5 CFR part 
1320, which implement the Paperwork Reduction Act of 1995 (Pub. L. 104-
13), require that interested members of the public and affected 
agencies have an opportunity to comment on information collection and 
recordkeeping activities (see 5 CFR 1320.8 (d)). This notice identifies 
an information collection activity that the Office of Youth, 
Partnerships and Service will submit to OMB for approval for the 
Department and its bureaus to continue to collect information from 
proposed donors relative to their relationship(s) with the Department. 
The Department and its individual bureaus all have gift acceptance 
authority. In support of the variety of donation authorities in the 
Department and increasing numbers of donations, it is the policy of the 
Department to ask those proposing to donate gifts valued at $25,000 or 
more to provide information regarding their relationship with the 
Department. The purpose of this policy is to ensure that the acceptance 
of a gift does not create legal or ethical issues for the Department, 
its bureaus, or potential donors. The information will be gathered 
through the use of a form.
    If this information were not collected from the prospective donor, 
the Department would have to collect the information. With nine major 
bureaus, 2400 locations and 70,000 employees, it is not possible to 
collect the information about a particular donor in a timely manner to 
respond to a proposed donation. Having the donor certify his or her 
interactions with the Department gives the staff reviewing the proposed 
donation basic information.

II. Method of Collection

    Individuals notifying the Department or one of its bureaus of a 
proposed offer of a gift valued at $25,000 or higher will be asked to 
submit a form listing several items of basic information.
    (1) Title: Donor Certification Form.

------------------------------------------------------------------------
         Information collected                Reason for collection
------------------------------------------------------------------------
Name, and indication whether executing   To identify the donor, and
 in individual capacity, or on behalf     whether the donor is acting
 of an organization.                      individually or on behalf of
                                          an organization.
Declaration whether the donor is         To assist the Department in
 involved with litigation or              determining whether there are
 controversy with the Department.         any issues associated with the
                                          proffer of the gift that need
                                          to be more closely examined.
Declaration whether the donor is         To assist the Department in
 engaged in any financial or business     determining whether there are
 relationship with the Department.        any issues associated with the
                                          proffer of the gift that need
                                          to be more closely examined.
Declaration whether the donor has been   To assist the Department in
 debarred, excluded or disqualified       determining whether there are
 from the nonprocurement common rule,     any issues associated with the
 or otherwise declared ineligible from    proffer of the gift that need
 doing business with any Federal agency.  to be more closely examined.
Declaration as to whether the donation   To assist the Department in
 is expected to be involved with          determining whether there are
 marketing or advertisting.               any issues associated with the
                                          proffer of the gift that need
                                          to be more closely examined.
Declaration whether the donor is         To assist the Department in
 seeking to attach conditions to the      determining whether there are
 donation.                                any issues associated with the
                                          proffer of the gift that need
                                          to be more closely examined.
Declaration whether this proposed        To assist the Department in
 donation is or is not part of a series   determining the scope and
 of donations to the Department.          context of the donation, and
                                          to assist in determining
                                          whether there are any issues
                                          associated with the proffer of
                                          the gift that need to be more
                                          closely examined.
Signature, Printed Name, Date,           To establish the contact
 Organization, Email address, City,       information of the potential
 State, Zip, and daytime or work phone    donor, and have the certifier
 number.                                  sign the certification form.
------------------------------------------------------------------------


[[Page 18851]]

III. Data

    (1) Title: Donor Certification Form.
    OMB Control Number: 1090-0009
    Type of Review: Information Collection: Renewal
    Affected Entities: Individuals or households, Businesses, Not-for-
profit institutions, Tribal governments.
    Estimated annual number of respondents: 555.
    Frequency of response: Once per prospective donation.
    (2) Annual reporting and recordkeeping burden:
    Estimated number of responses annually: 555.
    Estimated burden per response: 20 minutes.
    Total annual reporting: 185 hours.
    (3) Description of the need and use of the information: This 
information will provide Department staff with the basis for beginning 
the evaluation as to whether the Department will accept the proposed 
donation. The authorized employee will receive the donor certification 
form with the proposed donation. The employee will then review the 
totality of circumstances surrounding the proposed donation to 
determine whether the Department can accept the donation and maintain 
its integrity, impartiality, and public confidence.

IV. Request for Comments

    The Department of the Interior invites comments on:
    (a) Whether the collection of information is necessary for the 
proper performance of the functions of the agency, including whether 
the information will have practical utility;
    (b) The accuracy of the agency's estimate of the burden of the 
collection and the validity of the methodology and assumptions used;
    (c) Ways to enhance the quality, utility, and clarity of the 
information to be collected; and
    (d) Ways to minimize the burden of the collection of information on 
those who are to respond, including through the use of appropriate 
automated, electronic, mechanical, or other collection techniques or 
other forms of information technology.
    Burden means the total time, effort, or financial resources 
expended by persons to generate, maintain, retain, disclose or provide 
information to or for a federal agency. This includes the time needed 
to review instructions; to develop, acquire, install and utilize 
technology and systems for the purpose of collecting, validating and 
verifying information, processing and maintaining information, and 
disclosing and providing information; to train personnel and to be able 
to respond to a collection of information, to search data sources, to 
complete and review the collection of information; and to transmit or 
otherwise disclose the information.
    The comments, with names and addresses, will be available for 
public viewing. If you wish us to withhold your personal information, 
you must prominently state at the beginning of your comment what 
personal information you want us to withhold. We will honor your 
request to the extent allowable by law. Comments received, if any, will 
be available for public viewing by appointment only. You may schedule 
such an appointment by contacting the Office of Youth, Partnerships and 
Service at 1849 C Street NW., MS 3559 MIB, Washington, DC 20240, or 
telephone (202) 208-4881 to schedule an appointment to view any 
comments received. A valid picture identification is required for entry 
into the Department of the Interior.
    An agency may not conduct or sponsor, and a person is not required 
to respond to, a collection of information unless it displays a 
currently valid Office of Management and Budget control number.

    Dated: March 21, 2012.
Olivia Barton Ferriter,
Office of Youth, Partnerships and Service.
[FR Doc. 2012-7412 Filed 3-27-12; 8:45 am]
BILLING CODE 4310-RK-P


</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>