Information Collection

US Department of Justice Self Reportable Activities

IC 232919 under ICR 201808-1103-001 · OMB 1103-0119.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1103-0119 can be found here:

Documents and Forms

Document Name Document Type
Form 1103-NEW US Department of Justice Self Reportable Activities Form and Instruction
1103-NEW DOJ Self Reportable Activities JMD-SEPS iReporting Survey 1103-NEW.pdf jstars.eshp.doj.gov/jstars/page.request.do?page=page.public.incident.report Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	US Department of Justice Self Reportable Activities	Agency IC Tracking Number:	1103-NEW

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	1103-NEW	DOJ Self Reportable Activities	JMD-SEPS iReporting Survey 1103-NEW.pdf	https://jstars.eshp.doj.gov/jstars/page.request.do?page=page.public.incident.report	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title: Personnel Investigation and Security Clearance Records for the Department of Justice	FR Citation: 67 FR 59864

Number of Respondents: 35,000	Number of Respondents for Small Entity: 0

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	1,550	1,550
Annual IC Time Burden (Hours)	258	258
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.