Nondiscrimination in Federal Financial Assistance Programs; GSA Form 3702 and GSA Form XXXX

Forms and Documents

Document Name	Status
Form GSA XXXX Nondiscrimination in Federal Financial Assistance -- Compliance Questionnaire Form and Instruction	New
Form GSA 3702 Nondiscrimination in Federal Financial Assistance Programs; GSA Form 3702 Form and Instruction	Unchanged
3090-0310_Supporting Statement 2024.6.21.24.docx Supporting Statement A	2024-11-07

IC Document Collections

IC ID	Document Title	Status
272230	Nondiscrimination in Federal Financial Assistance -- Compliance Questionnaire Form and Instruction	New
223853	Nondiscrimination in Federal Financial Assistance Programs; GSA Form 3702 Form and Instruction	Unchanged

ICR Details

OMB Control No: 3090-0310	ICR Reference No: 202411-3090-003
Status: Received in OIRA	Previous ICR Reference No: 202301-3090-001
Agency/Subagency: GSA	Agency Tracking No:
Title: Nondiscrimination in Federal Financial Assistance Programs; GSA Form 3702 and GSA Form XXXX
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 11/07/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2026
Responses	1,275	1,200
Time Burden (Hours)	2,550	2,400
Cost Burden (Dollars)	73,350	69,000

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Abstract: GSA administers the Public Benefit Conveyance (PBC) program, which is considered a federal financial assistance program to which certain federal civil rights laws apply. In accordance with the authority granted the Attorney General of the United States under Executive Order 12250 (Leadership and Coordination of Nondiscrimination Laws) and Executive Order 14074 (Advancing Effective, Accountable Policing and Criminal Justice Practices To Enhance Public Trust and Public Safety), the U.S. Department of Justice (DOJ) requires that each federally assisted program provides for the collection of data and information from recipients of federal assistance sufficient to permit effective enforcement of Title VI of the Civil Rights Act of 1964, as amended (Title VI). (§ 28 CFR 42.406(a); DOJ’s Policy Guidance Document: “Enforcement of Title VI of the Civil Rights Act of 1964 and Related Statutes in Block Grant-Type Programs”, dated January 28, 1999). From time to time, the DOJ requests certain civil rights compliance information, which GSA is required to provide to the DOJ under Executive Order 14074.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 64462	08/07/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 88050	11/06/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Nondiscrimination in Federal Financial Assistance -- Compliance Questionnaire	GSA XXXX	Nondiscrimination in Federal Financial Assistance Compliance Questionnaire for Recipients
Nondiscrimination in Federal Financial Assistance Programs; GSA Form 3702	GSA 3702	Nondiscrimination in Federal Financial Assistance Compliance Questionnaire for Recipients

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ICR Summary of Burden

	Total Request	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	1,275	1,200	0	75	0	0
Annual Time Burden (Hours)	2,550	2,400	0	150	0	0
Annual Cost Burden (Dollars)	73,350	69,000	0	4,350	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Increased burden due to adding a duplicate form to the U.S. General Services Administration (GSA) form 3702 existing collection, referencing the federal real property conveyances under the Federal Public Benefit Conveyance Program.

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Annual Cost to Federal Government: $58,650

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 11/07/2024

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