Applicant Information Form

Forms and Documents

Document	Type	Status	Availability
Form 1-783 Applicant Information Form	Form	Modified	Available
1110-0052_Supplemental.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2013-05-16	Available
Changes_1-783.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2012-08-29	Available
1-783 83i-fill.pdf	Supplementary Document	Uploaded 2011-11-10	Available
1110-0052_Supporting Statement.docx	Supporting Statement A	Uploaded 2012-12-19	Available
CFR-2010-title28-vol1-sec16-341-783.pdf	Supplementary Document	Uploaded 2011-06-10	Available
CFR-2010-title28-1-873.pdf	Supplementary Document	Uploaded 2011-06-10	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
198010	Applicant Information Form	Form	Modified

ICR Details

OMB Control No: 1110-0052	ICR Reference No: 201305-1110-002
Status: Historical Active	Previous ICR Reference No: 201206-1110-002
Agency/Subagency: DOJ/FBI	Agency Tracking No:
Title: Applicant Information Form
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/22/2013
	Date Received in OIRA: 05/16/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2014	11/30/2014	11/30/2014
Responses	225,000	0	225,000
Time Burden (Hours)	11,250	0	11,250
Cost Burden (Dollars)	0	0	0

---

Abstract: The regulations under 28 United States Code (USC) 534, which authorizes the Federal Bureau of Investigation's (FBI's) acquisition, retention, and sharing of information does not prohibit the subjects of arrest and conviction records from having access to those records. Therefore, Title 28 Code of Federal Regulation (CFR) Part 16 was amended to include §16.30-16.34, which contains the regulations of the FBI concerning procedures to be followed when the subject of an identification record requests production of that record to review it or to obtain a change, correction, or update of that record.

---

Authorizing Statute(s): US Code: 28 USC 534 Name of Law: Acquisition, preservation, and exchange of identification records and information; appointment of
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 35022	06/15/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 52014	08/19/2011
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
Applicant Information Form	1-783	Applicant Information

---

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	225,000	225,000	0	0	0	0
Annual Time Burden (Hours)	11,250	11,250	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: $3,000,000

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

---

Common Form ICR:  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:

(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: 05/16/2013

---