Information Collection

FBI Whistleblower Request for Corrective Action Form

IC 227072 under ICR 201706-1105-001 · OMB 1105-0103.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0103 can be found here:

Documents and Forms

Document Name Document Type
Form 1105 - NEW OARM FBI Whistleblower Request for Corrective Action Form Form and Instruction
1105 - NEW OARM FBI Whistleblower Request for Corrective Action Form RCA Form.pdf www.justice.gov/oarm/page/file/934161/download Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FBI Whistleblower Request for Corrective Action Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1105 - NEW OARM	FBI Whistleblower Request for Corrective Action Form	RCA Form.pdf	https://www.justice.gov/oarm/page/file/934161/download	Yes	Yes	Fillable Fileable Signable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 10

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10	10
Annual IC Time Burden (Hours)	30	30
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.