Annual Certification Report and Equitable Sharing Agreement

Forms and Documents

Document Name	Status
Form 1123-0011 Annual Certification Report and Equitable Sharing Agreement Form and Instruction	Modified
1123-0011_LE Equipment WG Final Report (FINAL)_091515.pdf Supplementary Document	2015-09-15
1123-0011_83i-fill_091515.pdf Supplementary Document	2015-09-15
1123-0011 Updated AFMLS Supporting Statement_092115.doc Supporting Statement A	2015-09-22

IC Document Collections

IC ID	Document Title	Status
182734	Annual Certification Report and Equitable Sharing Agreement Form and Instruction	Modified

ICR Details

OMB Control No: 1123-0011	ICR Reference No: 202112-1123-001
Status: Received in OIRA	Previous ICR Reference No: 201810-1123-001
Agency/Subagency: DOJ/CD	Agency Tracking No: 1123-0011
Title: Annual Certification Report and Equitable Sharing Agreement
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/29/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	12/31/2021
Responses	7,600	7,600
Time Burden (Hours)	3,800	3,800
Cost Burden (Dollars)	0	0

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Abstract: Under the Attorney General's discretionary authority to share forfeited assets under 18 U.S.C. § 981(e)(2) and 21 U.S.C. § 881(e)(1)(A), the Asset Forfeiture and Money Laundering Section of the Criminal Division, would require accounting information from state and local law enforcement agencies which participate in the Department's Equitable Sharing Program in order to ensure compliance with Program guidelines.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 51197	09/14/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 71521	12/16/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Annual Certification Report and Equitable Sharing Agreement	1123-0011	Equitable Sharing Agreement and Certification

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ICR Summary of Burden

	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	7,600	7,600	0	0	0	0
Annual Time Burden (Hours)	3,800	3,800	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/29/2021

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