Freedom of Information/Privacy Act Record Request Form (INV 100)

Forms and Documents

Document Name	Status
Form INV 100 Freedom of Information/Privacy Act Record Request Form (INV 100) Form and Instruction	New
Supporting Statement-INV 100-November 20 2012 FINAL ROCIS.DOC Supporting Statement A	2013-03-28
2013-07202.pdf Supplementary Document	2013-03-28
INV 100, 60 day FRN, Vol. 77, No. 170, August 31, 2012, Pages 53237-53238.pdf Supplementary Document	2012-09-20

IC Document Collections

IC ID	Document Title	Status
200701	Freedom of Information/Privacy Act Record Request Form (INV 100) Form and Instruction	New

ICR Details

OMB Control No: 3206-0259	ICR Reference No: 201201-3206-009
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: OPM	Agency Tracking No:
Title: Freedom of Information/Privacy Act Record Request Form (INV 100)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/11/2013
	Date Received in OIRA: 03/28/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2016	36 Months From Approved
Responses	16,626	0	0
Time Burden (Hours)	1,386	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The proposed optional form INV 100 use is to standardize collection of data elements specific to FOIA and Privacy Act record requests submitted to OPM Federal Investigative Services (FIS). Standardization of the access process will increase the volume of perfected requests received and strike an appropriate balance between the burden to the public in submitting a request and FIS-FOI/PA being able to verify the identity of the requester thereby ensuring Privacy Act Protected records are not inappropriately released to third parties.

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Authorizing Statute(s): US Code: 5 USC CFR 294 Name of Law: Electronic Code of Federal Regulations
   US Code: 5 USC CFR 297 Name of Law: Electronic Code of Federal Regulations
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 53237	08/31/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 19025	03/28/2013
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Freedom of Information/Privacy Act Record Request Form (INV 100)	INV 100	Freedom of Information Act/ Privacy Act Request Form

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ICR Summary of Burden

	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	16,626	0	0	16,626	0	0
Annual Time Burden (Hours)	1,386	0	0	1,386	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Program office determined a uniform method of collecting Privacy Act and FOIA requests would help streamline the process and provide quicker service to the requester.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

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? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/28/2013

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