Certification of Identity and Consent Form

ICR 201610-1024-001

OMB: 1024-0280

Federal Form Document

IC Document Collections
ICR Details
1024-0280 201610-1024-001
Historical Active
DOI/NPS
Certification of Identity and Consent Form
Existing collection in use without an OMB Control Number   No
Regular
Approved without change 01/17/2017
Retrieve Notice of Action (NOA) 10/26/2016
  Inventory as of this Action Requested Previously Approved
01/31/2020 36 Months From Approved
2,000 0 0
100 0 0
0 0 0

The purpose of the collection is to enable the NPS to locate applicable records and to respond to requests made under the Freedom of Information Act and the Privacy Act of 1974. Information includes sufficient personally identifiable information and/or source documents as applicable. The detailed personal information, to include the date/place of birth, as well as the requestor’s Social Security Number, is needed to identify records unique to the requestor. Failure to provide the required information may result in the NPS being unable to take any action on the request.

US Code: 5 USC 552a Name of Law: Privacy Act
   US Code: 54 USC 100101 Name of Law: National Park Service Organic Act
   US Code: 5 USC 552 Name of Law: Freedom of Information Act
  
None

Not associated with rulemaking

  81 FR 2233 01/15/2016
81 FR 74478 10/26/2016
No

1
IC Title Form No. Form Name
Certification of Identity and Consent 10-945 Certification of Identity and Consent

  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 2,000 0 0 2,000 0 0
Annual Time Burden (Hours) 100 0 0 100 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is an existing collection in use without OMB approval.

$6,158
No
No
No
No
No
Uncollected
Madonna Baucum 202 354-1916 [email protected]

  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.
10/26/2016


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