Information Collection

Records Modification Form (FD-1115)

IC 215286 under ICR 202111-1110-001 · OMB 1110-0068.

Documents and Forms

Document Name Document Type
Form FD-1115 Records Modification Form (FD-1115) Form and Instruction
FD-1115 FBI Modification Form FD-1115 Form.docx Form and Instruction
FD-1115 FBI Modification Form FD-1115 Form.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

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 0.85 28 CFR 20.33

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FD-1115	FBI Modification Form	FD-1115 Form.docx		Yes	Yes	Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Criminal Investigation and Surveillance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 105	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 97 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	79,756	-39,537	119,293
Annual IC Time Burden (Hours)	6,646	-13,236	19,882
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.