Freedom of Information/Privacy Act Records Request

Freedom of Information/Privacy Act Record Request Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0412-0589 can be found here:

Documents and Forms

Document Name Document Type
2018 FOIA PAL Screen.docx Other-Privacy Statement
AID 507-1 Freedom of Information/Privacy Act Record Request Form AID 507-1-2014 7-23-14(31).doc Form and Instruction

Information Collection (IC) Details

IC Title:	Freedom of Information/Privacy Act Records Request	Agency IC Tracking Number:

Is this a Common Form? Yes		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 22 CFR 215.4

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Privacy Statement			2018 FOIA PAL Screen.docx		Yes	Yes	Fillable Fileable
Form and Instruction	AID 507-1	Freedom of Information/Privacy Act Record Request Form	AID 507-1-2014 7-23-14(31).doc		Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Executive Functions

Privacy Act System of Records
Title: Freedom of Information/Privacy Act Record Request	FR Citation: 79 FR 1

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	300	-300	600
Annual IC Time Burden (Hours)	150	60	90
Annual IC Cost Burden (Dollars)	0	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.