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OMB Control No: 1103-0016	ICR Reference No: 202306-1103-005
Status: Historical Inactive	Previous ICR Reference No: 202005-1103-001
Agency/Subagency: DOJ/DOJADM	Agency Tracking No: 1103-0016
Title: Certification of Identity
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Comment filed on proposed rule and continue	Conclusion Date: 10/05/2023
	Date Received in OIRA: 06/28/2023
Terms of Clearance: OMB files this comment in accordance with 5 CFR 1320.11( c ). This OMB action is not an approval to conduct or sponsor an information collection under the Paperwork Reduction Act of 1995. This action has no effect on any current approvals. If OMB has assigned this ICR a new OMB Control Number, the OMB Control Number will not appear in the active inventory. For future submissions of this information collection, reference the OMB Control Number provided. OMB files this comment in accordance with 5 CFR 1320.11( c ). This OMB action is not an approval to conduct or sponsor an information collection under the Paperwork Reduction Act of 1995. This action has no effect on any current approvals. If OMB has assigned this ICR a new OMB Control Number, the OMB Control Number will not appear in the active inventory. For future submissions of this information collection, reference the OMB Control Number provided. DOJ will address all public comments received in ICR from the NPRM.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2023	36 Months From Approved	10/31/2023
Responses	69,000	0	69,000
Time Burden (Hours)	34,500	0	34,500
Cost Burden (Dollars)	0	0	0

Abstract: This form is used to identity individuals requesting records on self or another individual under the Privacy Act, 5 U.S.C. Section 552a(i)(3) and in accordance with the provisions of 28 C.F.R., Section 16.41(d).

Authorizing Statute(s): US Code: 5 USC 552 Name of Law: Public information; agency rules, opinions, orders, records, and proceedings

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1105-AB66	Proposed rulemaking	88 FR 1012	01/06/2023

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Certification of Identity	DOJ-361

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

Annual Cost to Federal Government: $0

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. Yes

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. Yes

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

Agency Contact: Christina Troiani 202 514-5105

View ICR - OIRA Conclusion