Information Collection

Records Modification Form (FD-1115)

IC 215286 under ICR 201710-1110-007 · OMB 1110-0068.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1110-0068 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1110-0068 Records Modification Form (FD-1115)	Form and Instruction
1110-0068 Records Modification Form 1110-0068 FD-1115_form 2018.pdf	Form and Instruction

IC Title:

Records Modification Form (FD-1115)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 28 CFR 50.12 28 CFR 20.33 28 CFR 0.85

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1110-0068	Records Modification Form	1110-0068 FD-1115_form 2018.pdf		No		Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Criminal Investigation and Surveillance

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 43,584

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	119,293	-12,777	132,070
Annual IC Time Burden (Hours)	19,882	-2,129	22,011
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.