Office of the Secretary of Defense (OSD) Confidential Conflict-of-Interest Statement for Advisory Committee Members

ICR 201601-0704-001

OMB: 0704-0551

Federal Form Document

ICR Details
0704-0551 201601-0704-001
Historical Active
DOD/DODDEP 0704-AAIU
Office of the Secretary of Defense (OSD) Confidential Conflict-of-Interest Statement for Advisory Committee Members
Existing collection in use without an OMB Control Number   No
Regular
Approved without change 02/18/2016
Retrieve Notice of Action (NOA) 01/15/2016
DOD must report this collection as a violation in this year's Information Collection Budget.
  Inventory as of this Action Requested Previously Approved
02/28/2019 36 Months From Approved
125 0 0
125 0 0
906 0 0

The information request on this form is required by Title I of the Ethics in Government Act of 1978 (U.S.C. App.), Executive Order 12674, and 5 C.F.R. part 2634, subpart I, of the Office of Government Ethics regulations. The requested information is necessary to prevent conflicts of interest and to identify potential conflicts of individuals serving on certain OSD Advisory Committees.

US Code: 5 USC app., sec. 107(a) Name of Law: The Ethics in Government Act of 1978
   EO: EO 12674 Name/Subject of EO: Principles of Ethical Conduct for Government Officers and Employees
  
None

Not associated with rulemaking

  80 FR 19641 04/13/2015
81 FR 2203 01/15/2016
No

  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 125 0 0 125 0 0
Annual Time Burden (Hours) 125 0 0 125 0 0
Annual Cost Burden (Dollars) 906 0 0 906 0 0
Yes
Miscellaneous Actions
No
There is a change in burden because this is an existing collection without an OMB Control Number.

$4,854
No
No
No
No
No
Uncollected
Caitlyn Borghi 571 372-0492 caitlyn.a.borghi.ctr@mail.mil

  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.
01/15/2016


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