View RCF  - OIRA Conclusion

202308-1225-002CF
Historical Active 09/30/2025
DOL/DM
0607-1018 202202-0607-009
Certification of Identity (Form BC-300)
RCF New
 Approved without change   08/23/2023
Retrieve Notice of Action (NOA) 08/03/2023
The request for access to records must contain a verification of identity, including the requestor’s full name, current address, and date and place of birth, and be signed under penalty of perjury or notarized. Requests for the release of records will not be processed if DOL cannot confirm identity based on the information provided. Therefore, this information collection is necessary to prevent unauthorized disclosure of records of individuals maintained by DOL and allows parties to disclose or release their records to an attorney, accredited representative, qualified organization, or other third party.
None
 
Nicole Bouchet 202-693-0213 nicole.bouchet@dol.gov

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Certification of Identity (Form BC-300) 40 4 0 Form and Instruction BC-300 Certification of Identity

  Total Approved 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 40 0 0 40 0 0
Annual Time Burden (Hours) 4 0 0 4 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0

Yes
Miscellaneous Actions
No
DOL is requesting authorization to use this common form for the Certification of Identity in Privacy Act requests.