Reviewer Recruitment GenIC - ANA Panel Reviewer Profile Questionnaire

Request for Approval under the “Generic Clearance for Reviewer Recruitment”

(OMB Control Number: 0970-0477)

TITLE OF INFORMATION COLLECTION: Administration for Native Americans (ANA) Panel Reviewer Profile Questionnaire

PURPOSE: The purpose is to select qualified reviewers for Administration for Children and Families (ACF) review processes based on professional qualifications using data entered and documents provided by candidates. Example documents include writing samples and curriculum vitae and/or resume. These reviews are for ANA’s Annual Grant Reviews for its three main programs – Social and Economic Development, Language Preservation and Maintenance and Environmental Regulatory Enhancement. Applications competing for financial assistance under ANA will be reviewed and evaluated by objective review panels using only the criteria described in the Evaluation Criteria section of each funding opportunity. Each panel is composed of experts with knowledge and experience in the area under review. Generally, review panels include three reviewers and one chairperson. Reviewers can be pulled for ad hoc reviews as necessary, but atypical.

DESCRIPTION OF RESPONDENTS: Respondents are individuals interested in participating in ANA’s Annual Grant Funding Application Review as a peer reviewer or panel chairperson.

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Amy Zukowski, Division of Program Evaluation and Planning; Administration for Native Americans__

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
ANA Peer Panel Review Applicant	300	.4	120
Totals	300	.4	120

FEDERAL COST: The estimated annual cost to the Federal government is $7,003.20

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[x] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Instructions for completing Request for Approval under the “Generic For Reviewer Recruitment”

FORM AND INSTRUCTIONS

• All instruments must display the following required PRA information:

  • OMB Control Number: 0970-0477

Expiration date: 06/30/2023

• The following PRA Burden Statement. The following template can be used. For red text in brackets, choose the best option and delete the other bracketed option(s). Replace highlighted areas with content specific to your collection. 

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: [Through this information collection, ACF is gathering information to….]/[The purpose of this information collection is to….]. Public reporting burden for this collection of information is estimated to average XX hours per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB # is 0970-0477 and the expiration date is 06/30/2023. If you have any comments on this collection of information, please contact….

SUBMISSION FORM

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request.

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

PERSONALLY IDENTIFIABLE INFORMATION (PII): Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, Local, or Tribal Government; or (4) Federal Government. Only one type of respondent can be selected per row.

No. of Respondents: Provide an estimate of the number of respondents.

No. of Responses per Respondent: Provide the number of responses per respondent per year.

Burden per Response: Provide an estimate of the amount of time (in minutes) required for a response

Burden: Provide the burden hours by multiplying: (# of respondents) x (# or responses) x (burden per response).

FEDERAL COST: Provide an estimate of the annual cost to the federal government.

TYPE OF COLLECTION: Check all that apply. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

Submit all instruments, instructions, and scripts with the request.

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