Certification of Identity (Form BC-300)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form BC-300 Certification of Identity	Form and Instruction	Modified	Available
Form BC-300 Certification of Identity (Form BC-300)	Form and Instruction	Modified	Repair queued
Supporting Statement B Certification of Identity Form BC-300_04262022.docx	Supporting Statement B	Uploaded 2022-05-19	Repair queued
Supporting Statement A Certification of Identity Form BC-300_05182022.docx	Supporting Statement A	Uploaded 2022-05-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
250735	Certification of Identity (Form BC-300)	Form and Instruction	Modified	Certification of Identity
250735	Certification of Identity (Form BC-300)	Form and Instruction	Modified

ICR Details

OMB Control No: 0607-1018	ICR Reference No: 202202-0607-009
Status: Historical Active	Previous ICR Reference No: 202112-0607-002
Agency/Subagency: DOC/CENSUS	Agency Tracking No:
Title: Certification of Identity (Form BC-300)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/28/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/25/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2025	36 Months From Approved	09/30/2022
Responses	400	0	250
Time Burden (Hours)	40	0	25
Cost Burden (Dollars)	0	0	0

---

Abstract: The information requested on the Certification of Identity (Form BC-300), and the associated evidence, is collected under the Freedom of Information Act (FOIA), 5 U.S.C. § 552, and the Privacy Act of 1974, 5 U.S.C. § 552a. Per 28 C.F.R. §16.41(d), the request for access to records must contain a verification of identity, including the requestor’s full name, current address, and date and place of birth, and be signed under penalty of perjury or notarized. Requests for the release of records will not be processed if the Census Bureau cannot confirm identity based on the information provided. Therefore, this information collection is necessary to prevent unauthorized disclosure of records of individuals maintained by the Census Bureau and allows parties to disclose or release their records to an attorney, accredited representative, qualified organization, or other third party.

---

Authorizing Statute(s): US Code: 5 USC Section 552 Name of Law: Freedom of Information Act (FOIA)
   US Code: 5 USC Section 552a Name of Law: Privacy Act of 1974
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 15363	03/18/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 31519	05/24/2022
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Certification of Identity (Form BC-300)	BC-300	Certification of Identity

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	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	400	250	0	150	0	0
Annual Time Burden (Hours)	40	25	0	15	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The estimated number of annual respondents increased from 250 to 400, resulting in an increase of estimated annual burden from 25 hours to 40 hours.

---

Annual Cost to Federal Government: $98,652

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.     Yes

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.     Yes

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

---

Common Form ICR:  Yes

Description/Changes for Common Form Usage:  Submitting this request as a Common Form allows other federal agencies to request permission to utilize the Certification of Identity (Form BC-300) to verify the identity of requestors, which will help prevent the unauthorized disclosure of records of individuals and allows parties to disclose or release their records to an attorney, accredited representative, qualified organization, or other third party.

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title
DOC/NOAA	202209-0648-001CF	Certification of Identity (Form BC-300)	Active	Certification of Identity (Form BC-300)
DOL/DM	202308-1225-002CF	Certification of Identity (Form BC-300)	Historical Active	Certification of Identity (Form BC-300)
DOL/DM	202308-1225-004CF	Certification of Identity (Form BC-300)	Active	Certification of Identity (Form BC-300)

---

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: 05/25/2022

---