2012-17407. Notice of Request for Renewal of Information Collection for 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 announces that it has submitted a request for renewal of an information collection to the Office of Management and Budget (OMB), and requests public comments on this submission.

DATES:

OMB has up to 60 days to approve or disapprove the information collection request, but may respond after 30 days; therefore, public comments should be submitted to OMB by August 16, 2012, in order to be assured of consideration.

ADDRESSES:

Send your written comments by facsimile 202-395-5806 or email ([e-mail]) to the Office of Information and Regulatory Affairs, Office of Management and Budget, Attention: Department of the Interior Desk Officer (1090-0009). Also, please send a copy of your comments to Olivia Ferriter, Office of Youth, Partnerships and Service, U.S. Department of the Interior, MS 3530-MIB, 1849 C Street NW., Washington, DC 20240, or send an email to [e-mail]. Additionally, you may fax them to her at 202-208-4867. Individuals providing comments should reference Donor Certification Form.

FOR FURTHER INFORMATION CONTACT:

To request more information on this information collection you may call Olivia Ferriter at 202-208-4881 or email her at [e-mail]. You can see the entire information collection request as submitted to OMB at the Web site http://www.reginfo.gov. Follow the instructions to review Department of the Interior collections under review by OMB.

SUPPLEMENTARY INFORMATION:

I. Abstract

The OMB regulations at 5 CFR 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 has submitted to OMB for approval for the Department and its bureaus 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 is gathered through the use of the Donor Certification Form, DI-3680.

If this information were not collected from the prospective donor, the Department would have to collect the information. The information will be scattered throughout the Department. With nine major bureaus, 2,500 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 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 in an individual capacity, or on behalf of an organization	To identify the donor, and whether the donor is acting individually or on behalf of an organization.
Declaration whether the donor is involved with litigation or controversy with the Department	To assist the Department in determining whether there are any issues associated with the proffer of the gift that need to be more closely examined.
Declaration whether the donor is engaged in any financial or business relationship with the Department	To assist the Department in determining whether there are any issues associated with the proffer of the gift that need to be more closely examined.
Declaration whether the donor has been debarred, excluded or disqualified from the nonprocurement common rule, or otherwise declared ineligible from doing business with any Federal government agency	To assist the Department in determining whether there are any issues associated with the proffer of the gift that need to be more closely examined.
Declaration as to whether the donation is expected to be involved with marketing or advertising	To assist the Department in determining whether there are any issues associated with the proffer of the gift that need to be more closely examined.
Declaration whether the donor is seeking to attach conditions to the donation	To assist the Department in determining whether there are any issues associated with the proffer of the gift that need to be more closely examined.
Declaration whether this proposed donation is or is not part of a series of donations to the Department	To assist the Department in determining the scope and 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, Organization, Email address, City, State, Zip, and daytime or work phone number	To establish the contact information of the potential donor, and have the certifier sign the certification form.

Use of the information: The information collected will be used by the Department and its bureaus to assist them in properly considering proposed donations to the Department or to its bureaus in the amount of $25,000 or more. The information on the form, in conjunction with other information which may be known to one or more offices in the Department, will assist the Department in its efforts to maintain its integrity, impartiality, and the confidence of the public, in accepting donations.

III. Data

(1) Title: Donor Certification Form.

OMB Control Number: 1090-0009.

Type of Review: Renewal of current information collection approval.

Affected Entities: Individuals, Businesses, Not-for-profit institutions, Tribal Governments.

Estimated annual number of respondents: 552.

Frequency of response: Upon donation, generally no more than annual.

(2) Annual reporting and record keeping burden:

Estimated number of responses annually: 552.

Estimated burden per response: 20 minutes.

Total annual reporting burden: 184 hours.

(3) Description of the need and use of the information: This information provides 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.

As required under 5 CFR 1320.8(d), a Federal Register notice soliciting comments on the collection of information was published on March 28, 2012 (77 FR 18850). No comments were received. This notice provides the public with an additional 30 days in which to comment on the proposed renewal of this information collection activity.

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.

All written comments, with names and addresses, will be available for public inspection. 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. If you wish to view any comments received, you may do so by scheduling an appointment with the Office of Youth, Partnerships and Service at the above address. 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 OMB control number.

Olivia Ferriter,

Office of Youth, Partnerships and Service.