Information Collection

Certification of Identity and Consent

IC 224051 under ICR 202209-1024-007 · OMB 1024-0280.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-945 Certification of Identity and Consent	Form and Instruction
10-945 Certification of Identity and Consent Form 10-945 Certification of Identity and Consent 11.4.2019.docx	Form and Instruction
10-945 Certification of Identity and Consent Form 10-945 Certification of Identity and Consent 11.4.2019.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-945	Certification of Identity and Consent	Form 10-945 Certification of Identity and Consent 11.4.2019.docx		Yes	Yes	Fillable Printable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records

Title: Privacy Act Files â Interior, DOI-57

FR Citation: 81 FR 45527

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 20 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	100	100
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.