Form 14115 Independent Researcher Listing Application

OMB Control No. 3095-0054
Expiration date: 0X/XX/20XX

Independent Researcher Listing Application

Type of Application ☐ New

☐ Update to Current Listing

For Use at Archival Operations facilities, Washington, DC area facilities, and Presidential Library facilities
See Page 2 for Procedures and Conditions and the Privacy Act of 1974 and Paperwork Reduction Act Public Burden Statement

Researcher or Company Name*
Street and/or Post Office Box*
City, State, Zip Code*

Public Orders Telephone Number

Fax Number

Customer Service Telephone Number

Email Address

Web Page Address

Contact Person*
Research Specialty (may list specific record groups, records media, series, subjects, topics, etc.)*

National Archives and Records Administration (NARA) facilities in which you perform research (please mark all that apply)*:
☐ National Archives at Atlanta
☐ National Archives at Boston
☐ National Archives at Chicago
☐ National Archives at College Park
☐ National Archives at Denver
☐ National Archives at Fort Worth
☐ National Archives at Kansas City
☐ National Archives at New York City
☐ National Archives at Philadelphia
☐ National Archives at Riverside
☐ National Archives at San Francisco
☐ National Archives at Seattle
☐ National Archives at Washington, DC
☐ National Personnel Records Center (St. Louis-Civilian)
☐ National Personnel Records Center (St. Louis- Military

☐ Washington National Records Center (Suitland)

☐ Herbert Hoover Presidential Library and Museum
☐ Franklin D. Roosevelt Presidential Library and Museum
☐ Harry S. Truman Presidential Library and Museum
☐ Dwight D. Eisenhower Presidential Library and Museum
☐ John F. Kennedy Presidential Library and Museum
☐ Lyndon Baines Johnson Presidential Library and Museum
☐ Richard Nixon Presidential Library and Museum
☐ Gerald R. Ford Presidential Library
☐ Jimmy Carter Presidential Library and Museum
☐ Ronald Reagan Presidential Library and Museum
☐ George H.W. Bush Presidential Library and Museum
☐ William J. Clinton Presidential Library and Museum
☐ George W. Bush Presidential Library and Museum
☐ Other (Presidential Library or affiliated archive)_________________

I hereby authorize NARA to release to the public the information contained in this form for the purpose of providing a listing of
independent researchers under the conditions described on the back of this form.
Signature*

Date*

Completed questionnaires may be faxed to: 301-837-0459
or mailed to:

* Required Field

National Archives and Records Administration
RR2, Room 2500
RE: Independent Researcher Listing Application
8601 Adelphi Road
College Park, MD 20740-6001

For questions and comments, please feel free to telephone 301-837-3415 or email [email protected].
NATIONAL ARCHIVES AND RECORDS ADMINISTRATION

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NA Form 14115 (09-21)

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OMB Control No. 3095-0054
Expiration date: 0X/XX/20XX

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Procedures and Conditions for Inclusion in the Independent Researcher Listing for
NARA's Washington, DC, area, Regional Records Services Facilities, and Presidential Library Facilities
1. Any independent researcher who performs work at any NARA facility or NARA-affiliated archives may complete
the Independent Researcher Listing Application.
2. NARA does not require a fee for inclusion on the list. However, all required fields noted on the form must be
completed for inclusion on the listing.
3. The listing is compiled and disseminated as a service to the public. Copies of the listing will be available on
NARA's web site and at all archival reference units at the Washington, DC; College Park, MD; Archival
Operations Facilities; and Presidential Libraries.
4. Any change in an individual's listed information requires a resubmission of the form by the affected independent
researcher. Updates will be made whenever new information is submitted.
5. All independent researchers who wish to remain on the listing are required to certify annually that the information
we publish is current and accurate. Replies to our annual email notices must be received within 30 days. Those
independent researchers who do not reply will be stricken from the listing without further notification.
6. All independent researchers using NARA facilities and NARA-affiliated archives are expected to comply with
established research room procedures. Those found to be in violation of such procedures will be stricken from the
listing. Severe or repeated violations may also result in suspension of research room privileges in accordance with
36 CFR 1254, subpart B.
7. Soliciting, vending, and debt collection are prohibited on NARA property.
8. Any comments or complaints NARA receives regarding any individual independent researcher on the listing will
be forwarded to that researcher for resolution. However, complaints received on a regular basis regarding the
business practices of any independent researcher can result in removal from the listing.
9. NARA will not be responsible for any research and/or reproduction arrangements made between the independent
researcher and their clientele.
10. Inclusion on the list may not be viewed or advertised as NARA endorsement.
11. This listing is not considered part of the separate Vendor System used predominantly by NARA's Special Media
Archives Services Division at College Park, MD, nor is it part of any other contractual agreement.
12. This application is available on NARA's web site at www.archives.gov. You may also obtain a application
from, and send completed application and updates to, the following address:
National Archives and Records Administration
RR2, Room 2500
RE: Independent Researcher Listing Application
8601 Adelphi Road
College Park, MD 20740-6001
Or use our fax number: 301-837-0459.
In compliance with the Privacy Act of 1974, the following information is provided:
Solicitation of the information is authorized by 44 U.S.C. 2104. Disclosure of the information is voluntary; however, the effect of not providing the information is that a
researcher identification card will not be issued to the individual. A researcher identification card is required for research (other than microfilm records).
The information provided will be used to identify and record individuals who use records in the National Archives, field records services facilities, and Presidential libraries,
to determine records that the individual should use, to enable later contact with the individual if additional information is found or if problems with the records are
discovered, and to mail notices of events and programs of interest to users of the records and invitations to participate in customer satisfaction surveys.
The information may be transferred to appropriate Federal, State, local, or foreign agencies when relevant to civil, criminal, or regulatory investigations or prosecutions;
the
information may be disclosed by NARA to an expert, consultant, or a contractor of NARA to the extent necessary for them to assist NARA in the performance of its
duties; the information may be disclosed to the U.S. Department of Justice or to a court or adjudicative body in cases involving the mutilation or unlawful removal of the
records.
PAPERWORK REDUCTION ACT PUBLIC BURDEN STATEMENT
A Federal agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a current valid OMB control number.
The OMB Control No. for this information collection is 3095-0054. The information requested on this form is being collected and disseminated by NARA as a courtesy to
the public. Public burden reporting for this collection of information is estimated to be ten minutes per response, including time for reviewing instructions, and completing
and reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of the collection of information, including suggestions for
reducing this burden, to the National Archives and Records Administration (MP), 8601 Adelphi Road, College Park, MD 20740-6001. DO NOT SEND COMPLETED
FORMS TO THIS ADDRESS. PLEASE SEND COMPLETED FORMS TO THE ADDRESS SHOWN ABOVE IN ITEM 12.

NATIONAL ARCHIVES AND RECORDS ADMINISTRATION

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NA Form 14115 (09-21)