80 FR 75864 - Information Collection; Contractor Information Worksheet; GSA Form 850
GENERAL SERVICES ADMINISTRATION Federal Register Volume 80, Issue 233 (December 4, 2015)
Federal Register Volume 80, Issue 233 (December 4, 2015)
| Page Range | 75864-75865 | |
| FR Document | 2015-30698 |
[Federal Register Volume 80, Number 233 (Friday, December 4, 2015)] [Notices] [Pages 75864-75865] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2015-30698] ======================================================================= ----------------------------------------------------------------------- GENERAL SERVICES ADMINISTRATION [OMB Control No. 3090-0283; Docket 2015-0001; Sequence 16] Information Collection; Contractor Information Worksheet; GSA Form 850 AGENCY: Identity, Credential, and Access Management (ICAM) Division, Office of Security, Office of Mission Assurance (OMA), General Services Administration (GSA). ACTION: Notice of request for comments regarding an extension to an existing OMB clearance. ----------------------------------------------------------------------- SUMMARY: Under the provisions of the Paperwork Reduction Act, the Regulatory Secretariat Division will be submitting to the Office of Management and Budget (OMB) a request to review and approve a previously approved information collection requirement, with changes, expanding the coverage of the information collection of the Contractor Information Worksheet; GSA Form 850. GSA requires OMB approval for this collection to make determinations on granting unescorted physical access to GSA-controlled facilities and/or logical access to GSA-controlled information systems. The approval is critical for GSA to continue following contractor onboarding processes required for working on GSA contracts. An updated System of Record Notice (SORN) was published in the Federal Register at 79 FR 47139, on August 12, 2014. DATES: Submit comments on or before: February 2, 2016. ADDRESSES: Submit comments identified by Information Collection 3090- 0283, Contractor Information Worksheet; GSA Form 850, by any of the following methods:Regulations.gov: http://www.regulations.gov. Submit comments via the Federal eRulemaking portal by searching the OMB control number. Select the link ``Submit a Comment'' that corresponds with ``Information Collection 3090-0283, Contractor Information Worksheet; GSA Form 850''. Follow the instructions provided at the ``Submit a Comment'' screen. Please include your name, company name (if any), and ``Information Collection 3090-0283, Contractor Information Worksheet; GSA Form 850'' on your attached document. Mail: General Services Administration, Regulatory Secretariat Division (MVCB), 1800 F Street NW., Washington, DC 20405. ATTN: Ms. Flowers/IC 3090-0283, Contractor Information Worksheet; GSA Form 850. Instructions: Please submit comments only and cite Information Collection 3090-0283, Contractor Information Worksheet; GSA Form 850, in all correspondence related to this collection. Comments received generally will be posted without change to http://www.regulations.gov, including any personal and/or business confidential information provided. To confirm receipt of your comment(s), please check www.regulations.gov, approximately two to three days after submission to verify posting (except allow 30 days for posting of comments submitted by mail). FOR FURTHER INFORMATION CONTACT: Mr. Phil Ahn, Deputy Director, OMA Identity Credential and Access Management Division, GSA, telephone 202- 501-2447 or via email at [email protected]. SUPPLEMENTARY INFORMATION: A. Purpose The U.S. Government conducts criminal checks to establish that applicants or incumbents working for the Government under contract may have unescorted access to federally controlled facilities. GSA uses the Contractor Information Worksheet; GSA Form 850, and digitally captured fingerprints to conduct a FBI National Criminal Information Check (NCIC) for each contractor's physical access determination to GSA- controlled facilities and/or logical access to GSA-controlled information systems. Manual fingerprint card SF-87 is used for exception cases such as contractor's significant geographical distance from fingerprint enrollment sites. The Office of Management and Budget (OMB) Guidance M-05-24 for Homeland Security Presidential Directive (HSPD) 12, authorizes Federal departments and agencies to ensure that contractors have limited/ controlled access to facilities and information systems. GSA Directive CIO P 2181.1 Homeland Security Presidential Directive-12, Personal Identity Verification and Credentialing (available at http://www.gsa.gov/hspd12), states that GSA contractors must undergo a minimum of an FBI National Criminal Information Check (NCIC) to receive unescorted physical access to GSA-controlled facilities and/or logical access to GSA-controlled information systems. Contractors' Social Security Number is needed to keep records accurate, because other people may have the same name and birth date. Executive Order 9397, Numbering System for Federal Accounts Relating to Individual Persons, also allows Federal agencies to use this number to help identify individuals in agency records. B. Annual Reporting Burden Respondents: 25,000. Responses per Respondent: 1. Total Annual Responses: 25,000. Hours per Response: .25. Total Burden Hours: 6,250. C. Public Comments Public comments are particularly invited on: Whether this collection of information is necessary and whether it will have practical utility; whether our estimate of the public burden of this collection of information is accurate, and based on valid assumptions and methodology; ways to enhance the quality, utility, and clarity of the information to be collected. Obtaining Copies of Proposals: Requesters may obtain a copy of the [[Page 75865]] information collection documents from the General Services Administration, Regulatory Secretariat Division (MVCB), 1800 F Street NW., Washington, DC 20405, telephone 202-501-4755. Please cite OMB Control No. 3090-0283, Contractor Information Worksheet; GSA Form 850 in all correspondence. The form can be downloaded from the GSA Forms Library at http://www.gsa.gov/forms. Type GSA 850 in the form search field. Dated: November 25, 2015. David A. Shive, Chief Information Officer. [FR Doc. 2015-30698 Filed 12-3-15; 8:45 am] BILLING CODE 6820-34-P
![75864 Federal Register / Vol. 80, No. 233 / Friday, December 4, 2015 / Notices
Governors not later than December 31, Contractor Information Worksheet; GSA A. Purpose
2015. Form 850. The U.S. Government conducts
A. Federal Reserve Bank of New York GSA requires OMB approval for this criminal checks to establish that
(Ivan Hurwitz, Vice President) 33 collection to make determinations on applicants or incumbents working for
Liberty Street, New York, New York granting unescorted physical access to the Government under contract may
10045–0001: GSA-controlled facilities and/or logical have unescorted access to federally
1. The Adirondack Trust Company access to GSA-controlled information controlled facilities. GSA uses the
Employee Stock Ownership Trust, systems. The approval is critical for Contractor Information Worksheet; GSA
Saratoga Springs, New York; to acquire GSA to continue following contractor Form 850, and digitally captured
additional voting shares of 473 onboarding processes required for fingerprints to conduct a FBI National
Broadway Holding Corporation, and working on GSA contracts. An updated Criminal Information Check (NCIC) for
also acquire additional voting shares of System of Record Notice (SORN) was each contractor’s physical access
The Adirondack Trust Company, both published in the Federal Register at 79 determination to GSA-controlled
in Saratoga Springs, New York. FR 47139, on August 12, 2014. facilities and/or logical access to GSA-
B. Federal Reserve Bank of Cleveland
DATES:Submit comments on or before: controlled information systems. Manual
(Nadine Wallman, Vice President) 1455
February 2, 2016. fingerprint card SF–87 is used for
East Sixth Street, Cleveland, Ohio
exception cases such as contractor’s
44101–2566: ADDRESSES: Submit comments significant geographical distance from
1. KeyCorp, Cleveland, Ohio; to identified by Information Collection fingerprint enrollment sites.
acquire First Niagara Financial Group, 3090–0283, Contractor Information The Office of Management and Budget
Inc., Buffalo, New York, and thereby Worksheet; GSA Form 850, by any of (OMB) Guidance M–05–24 for
indirectly acquire First Niagara Bank, the following methods: Homeland Security Presidential
NA, Buffalo, New York. Comments also
may be sent to • Regulations.gov: http:// Directive (HSPD) 12, authorizes Federal
www.regulations.gov. departments and agencies to ensure that
comments.applications@clev.frb.gov.
Submit comments via the Federal contractors have limited/controlled
C. Federal Reserve Bank of St. Louis
eRulemaking portal by searching the access to facilities and information
(Yvonne Sparks, Community
OMB control number. Select the link systems. GSA Directive CIO P 2181.1
Development Officer) P.O. Box 442, St.
‘‘Submit a Comment’’ that corresponds Homeland Security Presidential
Louis, Missouri 63166–2034:
with ‘‘Information Collection 3090– Directive-12, Personal Identity
1. Stone Bancshares, Inc., Mountain
0283, Contractor Information Verification and Credentialing (available
View, Arkansas, to become a bank
Worksheet; GSA Form 850’’. Follow the at http://www.gsa.gov/hspd12), states
holding company by acquiring 100
instructions provided at the ‘‘Submit a that GSA contractors must undergo a
percent of the voting shares of Stone
Comment’’ screen. Please include your minimum of an FBI National Criminal
Bank, Mountain View, Arkansas.
name, company name (if any), and Information Check (NCIC) to receive
Board of Governors of the Federal Reserve unescorted physical access to GSA-
System, December 1, 2015. ‘‘Information Collection 3090–0283,
Contractor Information Worksheet; GSA controlled facilities and/or logical
Michael J. Lewandowski, access to GSA-controlled information
Form 850’’ on your attached document.
Associate Secretary of the Board. systems.
[FR Doc. 2015–30648 Filed 12–3–15; 8:45 am]
• Mail: General Services Contractors’ Social Security Number
Administration, Regulatory Secretariat is needed to keep records accurate,
BILLING CODE 6210–01–P
Division (MVCB), 1800 F Street NW., because other people may have the same
Washington, DC 20405. ATTN: Ms. name and birth date. Executive Order
Flowers/IC 3090–0283, Contractor 9397, Numbering System for Federal
GENERAL SERVICES Information Worksheet; GSA Form 850.
ADMINISTRATION Accounts Relating to Individual
Instructions: Please submit comments Persons, also allows Federal agencies to
[OMB Control No. 3090–0283; Docket 2015– only and cite Information Collection use this number to help identify
0001; Sequence 16] 3090–0283, Contractor Information individuals in agency records.
Information Collection; Contractor Worksheet; GSA Form 850, in all
correspondence related to this B. Annual Reporting Burden
Information Worksheet; GSA Form 850
collection. Comments received generally Respondents: 25,000.
AGENCY: Identity, Credential, and will be posted without change to http:// Responses per Respondent: 1.
Access Management (ICAM) Division, www.regulations.gov, including any Total Annual Responses: 25,000.
Office of Security, Office of Mission personal and/or business confidential Hours per Response: .25.
Assurance (OMA), General Services information provided. To confirm Total Burden Hours: 6,250.
Administration (GSA). receipt of your comment(s), please
C. Public Comments
ACTION: Notice of request for comments check www.regulations.gov,
regarding an extension to an existing approximately two to three days after Public comments are particularly
OMB clearance. submission to verify posting (except invited on: Whether this collection of
allow 30 days for posting of comments information is necessary and whether it
SUMMARY: Under the provisions of the submitted by mail). will have practical utility; whether our
asabaliauskas on DSK5VPTVN1PROD with NOTICES
Paperwork Reduction Act, the estimate of the public burden of this
FOR FURTHER INFORMATION CONTACT: Mr.
Regulatory Secretariat Division will be collection of information is accurate,
Phil Ahn, Deputy Director, OMA
submitting to the Office of Management and based on valid assumptions and
Identity Credential and Access
and Budget (OMB) a request to review methodology; ways to enhance the
Management Division, GSA, telephone
and approve a previously approved quality, utility, and clarity of the
202–501–2447 or via email at
information collection requirement, information to be collected.
phillip.ahn@gsa.gov.
with changes, expanding the coverage of Obtaining Copies of Proposals:
the information collection of the SUPPLEMENTARY INFORMATION: Requesters may obtain a copy of the
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![Federal Register / Vol. 80, No. 233 / Friday, December 4, 2015 / Notices 75865
information collection documents from responses; and (e) Assess information lived in the study area for at least 5
the General Services Administration, collection costs. years. Also, participants must consent to
Regulatory Secretariat Division (MVCB), To request additional information on receive prenatal care and deliver at one
1800 F Street NW., Washington, DC the proposed project or to obtain a copy of the healthcare facilities that are
20405, telephone 202–501–4755. Please of the information collection plan and taking part in the study.
cite OMB Control No. 3090–0283, instruments, call (404) 639–7570 or Since 2013, over 525 mother-infant
Contractor Information Worksheet; GSA send an email to omb@cdc.gov. Direct pairs and over 160 fathers have been
Form 850 in all correspondence. The written comments and/or suggestions enrolled. Biological sample analysis,
form can be downloaded from the GSA regarding the items contained in this surveys, and developmental screenings
Forms Library at http://www.gsa.gov/ notice to the Attention: CDC Desk are performed for each participant. An
forms. Type GSA 850 in the form search Officer, Office of Management and estimated 675 biomonitoring samples
field. Budget, Washington, DC 20503 or by fax have been analyzed for 36 metals/
to (202) 395–5806. Written comments metalloids including uranium, arsenic,
Dated: November 25, 2015.
should be received within 30 days of lead and mercury. Home environmental
David A. Shive, this notice.
Chief Information Officer. assessments (HEAs), conducted by field
[FR Doc. 2015–30698 Filed 12–3–15; 8:45 am] Proposed Project research staff, consist of gamma
Prospective Birth Cohort Study radiation surveys, indoor air radon tests,
BILLING CODE 6820–34–P
Involving Environmental Uranium and dust sample analysis of the
Exposure in the Navajo Nation (OMB participants’ primary residence during
Control No. 0923–0046, Expiration, pregnancy, and over 400 HEAs have
DEPARTMENT OF HEALTH AND been completed to date. Mothers must
2/29/2016)—Extension—Agency for
HUMAN SERVICES be present at home when field research
Toxic Substances and Disease Registry
(ATSDR). staff conduct the HEA. Study
Agency for Toxic Substances and participants receive report back letters
Disease Registry Background and Brief Description on their biomonitoring and HEA results
[30Day–16–0046] The Navajo Nation is the largest to inform them of uranium and other
Alaska Native/American Indian heavy metals in their bodies and in and
Agency Forms Undergoing Paperwork Reservation in the United States. From around their home environment.
Reduction Act Review 1948 to 1986, many uranium mining The survey instruments for pregnant
and milling operations took place in the mothers include the following:
The Agency for Toxic Substances and Navajo Nation, leaving a large amount of
Disease Registry (ATSDR) has submitted Eligibility Form, Mother Enrollment
uranium contamination on the Survey, Ages and Stages Questionnaire
the following information collection reservation. The House Committee on
request to the Office of Management and (ASQ), Mullen Scales for Early Learning
Oversight and Government Reform (MSEL), Postpartum Survey (2 months),
Budget (OMB) for review and approval requested that federal agencies develop
in accordance with the Paperwork Postpartum Survey (6,9,12 months),
a plan to address health and Food Frequency Questionnaire/WIC
Reduction Act of 1995. The notice for environmental impacts of uranium
the proposed information collection is Intake Form, and Home Environmental
contamination in the Navajo Nation. Assessments. An enrollment survey for
published to obtain comments from the As a result in 2013, ATSDR and its
public and affected agencies. fathers who agree to participate is also
research partners (University of New administered. Follow-up assessments
Written comments and suggestions Mexico Community Environmental
from the public and affected agencies including the Ages & Stages
Health Program [UNM–CEHP], Navajo Questionnaire and biomonitoring at 2, 6,
concerning the proposed collection of Area Indian Health Service [NAIHS],
information are encouraged. Your 9 and 12 months are currently being
Navajo Nation Department of Health conducted for the 387 infants delivered
comments should address any of the [NNDOH], Navajo Nation
following: (a) Evaluate whether the to date.
Environmental Protection Agency
proposed collection of information is [NNEPA], and Navajo culture and Community Health and
necessary for the proper performance of language specialists) initiated a research Environmental Research Specialists
the functions of the agency, including study titled ‘‘Prospective Birth Cohort (CHERS) administer the surveys using a
whether the information will have Study Involving Environmental CDC-approved electronic data entry
practical utility; (b) Evaluate the Uranium Exposure in the Navajo system. Survey instruments are used to
accuracy of the agencies estimate of the Nation’’ (OMB Control No. 0923–0046; collect demographic information and to
burden of the proposed collection of expiration date 02/29/2016). The goal of assess potential environmental health
information, including the validity of the research is to better understand and risks and mother-child interactions. The
the methodology and assumptions used; prevent unfavorable child and maternal final format of the survey instruments is
(c) Enhance the quality, utility, and health outcomes potentially related to based on review and input from the
clarity of the information to be prenatal exposures to uranium. As Navajo Nation community liaison group
collected; (d) Minimize the burden of ATSDR has received supplemental and associated Navajo staff to address
the collection of information on those funding to continue the study, a three issues such as cultural sensitivity,
who are to respond, including through year extension for PRA clearance is comprehension, and language
asabaliauskas on DSK5VPTVN1PROD with NOTICES
the use of appropriate automated, requested to allow further recruitment translation.
electronic, mechanical, or other of mother-infant pairs. There is no cost to the respondents
technological collection techniques or Participants include Native American other than their time to participate in
other forms of information technology, mothers from age 14 to 45 with the study. The total estimated annual
e.g., permitting electronic submission of verification of pregnancy who have burden hours equals 4,455.
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Document Created: 2015-12-14 13:53:00
Document Modified: 2015-12-14 13:53:00
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice of request for comments regarding an extension to an existing OMB clearance. | |
| Dates | Submit comments on or before: February 2, 2016. | |
| Contact | Mr. Phil Ahn, Deputy Director, OMA Identity Credential and Access Management Division, GSA, telephone 202- 501-2447 or via email at [email protected] | |
| FR Citation | 80 FR 75864 |
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