Information Collection

Freedom of Information/Privacy Act Records Request

IC 212451 under ICR 201711-0412-002 · OMB 0412-0589.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.