Freedom of Information/Privacy Act Request

ICR 199905-1115-001

OMB: 1115-0087

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
11988 Migrated
ICR Details
1115-0087 199905-1115-001
Historical Active 199810-1115-001
DOJ/INS
Freedom of Information/Privacy Act Request
Revision of a currently approved collection   No
Regular
Approved without change 06/11/1999
Retrieve Notice of Action (NOA) 05/07/1999
  Inventory as of this Action Requested Previously Approved
06/30/2002 06/30/2002 06/30/1999
100,000 0 100,000
25,000 0 25,000
0 0 0

This form is provided as a convenient means for persons to provide data necessary for identification of a particular record desired under FOIA/PA.

None
None


No

1
IC Title Form No. Form Name
Freedom of Information/Privacy Act Request FORM-G-639

  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 100,000 100,000 0 0 0 0
Annual Time Burden (Hours) 25,000 25,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/07/1999


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