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OMB Control No: 1103-0119	ICR Reference No: 202507-1103-001
Status: Received in OIRA	Previous ICR Reference No: 202203-1103-001
Agency/Subagency: DOJ/DOJADM	Agency Tracking No: 1103-0119
Title: US Department of Justice Self Reportable Activities
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 07/07/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	1,550	0
Time Burden (Hours)	258	0
Cost Burden (Dollars)	0	0

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: Karen Daniels 202 514-2351 karen.daniels@usdoj.gov