Blood Donor Locator Service (BDLS)

ICR 201207-0960-006

OMB: 0960-0501

Federal Form Document

Forms and Documents
Document
Name
Status
Supporting Statement A
2012-10-24
IC Document Collections
IC ID
Document
Title
Status
9399
Modified
ICR Details
0960-0501 201207-0960-006
Historical Active 200908-0960-010
SSA
Blood Donor Locator Service (BDLS)
Extension without change of a currently approved collection   No
Regular
Approved without change 11/13/2012
Retrieve Notice of Action (NOA) 10/31/2012
  Inventory as of this Action Requested Previously Approved
11/30/2015 36 Months From Approved 01/31/2013
50 0 50
13 0 13
0 0 0

This regulation requires requesting state agencies to provide the names and Social Security Numbers of blood donors, and a statement that the donor's blood tested positive for human immunodeficiency virus (HIV) to SSA's Blood Donor Locator Service when blood donor facilities have identified donors as testing positive for HIV. This information is used by SSA to furnish the state agencies with the blood donors' address information for the purpose of notifying them. Respondents are state agencies acting on behalf of blood donor facilities.

US Code: 42 USC 1320b-11 Name of Law: Social Security Act
  
None

Not associated with rulemaking

  77 FR 47908 08/10/2012
77 FR 65044 10/24/2012
No

1
IC Title Form No. Form Name
Blood Donor Locator Service (BDLS)

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 50 50 0 0 0 0
Annual Time Burden (Hours) 13 13 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$2,500
No
No
No
No
No
Uncollected
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
10/31/2012


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