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

Forms and Documents

Document Name	Status
Form INV 100 INV 100 - FREEDOM OF INFORMATION / PRIVACY ACT RECORD REQUEST FORM Form and Instruction	Unchanged
INV 100-July 2017 Non-Substantive update-Mocked Up.pdf Justification for No Material/Nonsubstantive Change	2017-09-08
INV 100-Non-Substantive Change Justification Statement.docx Justification for No Material/Nonsubstantive Change	2017-09-08
2016-10060_3206–0259.pdf Supplementary Document	2016-04-29
INV 100 Supporting Statement--ROCIS FINAL 3-22-16.doc Supporting Statement A	2016-04-26
INV 100, 60 Day FRN, Vol. 81, No. 11, January 19, 2016, Page 2923.pdf Supplementary Document	2016-01-20

IC Document Collections

IC ID	Document Title	Status
200701	INV 100 - FREEDOM OF INFORMATION / PRIVACY ACT RECORD REQUEST FORM Form and Instruction	Unchanged

ICR Details

OMB Control No: 3206-0259	ICR Reference No: 201709-3206-010
Status: Historical Active	Previous ICR Reference No: 201709-3206-001
Agency/Subagency: OPM	Agency Tracking No:
Title: Freedom of Information/Privacy Act Record Request Form (INV 100)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/01/2017
	Date Received in OIRA: 09/22/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	12/31/2017
Responses	15,682	0	15,682
Time Burden (Hours)	1,307	0	1,307
Cost Burden (Dollars)	0	0	0

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Abstract: The Freedom of Information/Privacy Act Record Request Form, INV 100, is an information collection completed by individuals submitting Freedom of Information (FOIA), Privacy Act, and Amendment record requests to OPM’s Federal Investigative Services (FIS), Freedom of Information and Privacy Act (FOI/PA) office. OPM’s FIS-FOI/PA office utilizes the optional form INV 100 to standardize collection of data elements specific to the types of record requests. Current record requests can be submitted to FIS-FOI/PA in a format chosen by the requester. Often, requests are missing data elements which require contact with the requester, thereby adding time to the process. Standardization of the 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 fulfill FOIA, Privacy Act, and Amendment requests in an efficient manner. OPM proposes non substantive changes to the form.

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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:
	81 FR 11	01/19/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 83	04/29/2016
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
INV 100 - FREEDOM OF INFORMATION / PRIVACY ACT RECORD REQUEST FORM	INV 100	Freedom of Information/Privacy Act Record 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	15,682	15,682	0	0	0	0
Annual Time Burden (Hours)	1,307	1,307	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: $0

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 09/22/2017

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