Freedom of Information Act (FOIA) Third Party Perjury Form

ICR 202009-1880-001

OMB: 1880-0545

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2021-03-15
IC Document Collections
IC ID
Document
Title
Status
213161 Modified
ICR Details
1880-0545 202009-1880-001
Received in OIRA 201711-1880-001
ED/OM ED-2021-SCC-0001
Freedom of Information Act (FOIA) Third Party Perjury Form
Extension without change of a currently approved collection   No
Regular 03/18/2021
  Requested Previously Approved
36 Months From Approved 03/31/2021
62,000 62,000
31,000 31,000
0 0

This collection is necessary to certify the identity of individuals requesting information under the Freedom of Information Act (FOIA) and Privacy Act (PA). This certification is required under 5 U.S.C. Section 552a(b). The form is used by Privacy Act requesters to obtain personal records via regular mail, fax or email. The department will use the information to help identify first-party or third party requesters with same or similar name when requesting retrieval of their own documents.

US Code: 5 USC 552(a)(b) Name of Law: Privacy Act
  
None

Not associated with rulemaking

  86 FR 1953 01/11/2021
86 FR 14742 03/18/2021
Yes

1
IC Title Form No. Form Name
Perjury Form ED-EVM.001.1 Perjury Form

  Total Request 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 62,000 62,000 0 0 0 0
Annual Time Burden (Hours) 31,000 31,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
No
Elise Cook 202 401-3769

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
03/18/2021


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