Applicant Information Form 1-783

Forms and Documents

Document Name	Status
Form 1-783 Applicant Information Form Form	Modified
1110-0052_Signature.pdf Supplementary Document	2014-05-01
1110-0052_Law.pdf Supplementary Document	2014-05-01
1110-0052_83I.pdf Supplementary Document	2014-05-01
1110-0052_Supporting Statement.docx Supporting Statement A	2014-08-13

IC Document Collections

IC ID	Document Title	Status
198010	Applicant Information Form Form	Modified

ICR Details

OMB Control No: 1110-0052	ICR Reference No: 201507-1110-005
Status: Historical Active	Previous ICR Reference No: 201404-1110-005
Agency/Subagency: DOJ/FBI	Agency Tracking No:
Title: Applicant Information Form 1-783
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/30/2015
	Date Received in OIRA: 11/17/2015
Terms of Clearance: This collection is approved for 1 year while DOJ continues to develop a fully electronic version of the collection. OMB requests that upon re-submission DOJ include in the supporting statement a report on progress made towards a fully electronic version of the collection.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	36 Months From Approved	12/31/2015
Responses	309,345	0	309,345
Time Burden (Hours)	25,779	0	25,779
Cost Burden (Dollars)	0	0	0

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Abstract: DOJ's FBI CJIS is requesting PRA extension of a currently approved collection that is utilized to obtain mandatory information necessary to process an individual's request for his/her identity history information.

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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

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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:
	80 FR 50324	08/19/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 63254	10/19/2015
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
Applicant Information Form	1-783	Applicant Information

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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	309,345	309,345	0	0	0	0
Annual Time Burden (Hours)	25,779	25,779	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:

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Annual Cost to Federal Government: $704,895

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: 11/17/2015

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