Application for certificates of Pardon for the Offense of Simple Possession of Marijuana - E.O.

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
APPLICATION FOR CERTIFICATE OF PARDON FOR SIMPLE POSSESSION OF MARIJUANA	Form and Instruction	New	Available
Application for Certificate of Pardon for Simple Possession of Marijuana	Form and Instruction	New	Repair queued
APPLICATION FOR CERTIFICATE OF PARDON FOR SIMPLE POSSESSION OF MARIJUANA	Form	Removed	Available
Application for Pardon Certificate	Form	Removed	Repair queued
PARDON EMERGENCY CLEARANCE REQUEST OMB.2.8.23.docx	Supplementary Document	Uploaded 2023-02-08	Available
PARDON EMERGENCY CLEARANCE REQUEST OMB.2.8.23.docx	Supplementary Document	Uploaded 2023-02-08	Repair queued
Supporting Statement for Paperwork Reduction Act Submission--Pardon proclamation 2.2.23.docx	Supporting Statement A	Uploaded 2023-02-08	Available
Supporting Statement for Paperwork Reduction Act Submission--Pardon proclamation 2.2.23.docx	Supporting Statement A	Uploaded 2023-02-08	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
258401	Application for Certificate of Pardon for Simple Possession of Marijuana	Form and Instruction	New	APPLICATION FOR CERTIFICATE OF PARDON FOR SIMPLE POSSESSION OF MARIJUANA
258401	Application for Certificate of Pardon for Simple Possession of Marijuana	Form and Instruction	New
256367	Application for Pardon Certificate	Form	Removed	APPLICATION FOR CERTIFICATE OF PARDON FOR SIMPLE POSSESSION OF MARIJUANA
256367	Application for Pardon Certificate	Form	Removed

ICR Details

OMB Control No: 1123-0014	ICR Reference No: 202302-1123-003
Status: Historical Active	Previous ICR Reference No: 202210-1123-002
Agency/Subagency: DOJ/CD	Agency Tracking No:
Title: Application for certificates of Pardon for the Offense of Simple Possession of Marijuana - E.O.
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 02/09/2023
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/09/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/08/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2023	6 Months From Approved	04/30/2023
Responses	20,000	0	20,000
Time Burden (Hours)	0	0	40,000
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this collection is to gather information necessary to enable the Office of the Pardon Attorney, U.S. Department of Justice to expeditiously administer the provisions of the Executive Order 10467, a proclamation granting pardons to individuals charged or convicted of simple possession of marijuana. The collection will enable individuals to apply for certificates of pardon, restoring political, civil, and other rights by implementing a process to provide certificates of pardon as provided by the order.

Emergency Justfication: The President issued a Proclamation on Granting Pardon for the Offense of Simple Possession Marijuana (Proclamation) on October 6, 2022. In that proclamation, he directed the Attorney General, acting through the Pardon Attorney, to develop procedures to “administer and effectuate the issuance of certificates of pardon to eligible applicants …. as soon as reasonably practicable.” The Proclamation specifically commands the Pardon Attorney to “develop and announce application procedures.” In accordance with the President’s direction, the Pardon Attorney has developed a Certificate of Pardon Application for Simple Marijuana Possession form (Certificate Application). The form collects information from potential pardon recipients to enable the Pardon Attorney to determine whether the applicant qualifies for pardon under the subject Proclamation. The information collection requests information from the applicant, confirming that the petitioner is U.S. citizen or lawful permanent resident who was lawfully in the country at the time the marijuana offense occurred; information regarding the whether the person is currently a lawful permanent resident and the date that status was attained, a citizen by birth, or a citizen by naturalization, and if naturalized, the date of the naturalization; the alien registration or citizenship number of lawful permanent resident or naturalized citizen applicants; information regarding the specific court in which the applicant was charged or convicted and the date of said conviction, if any; information regarding the applicant’s race, gender, and ethnicity; identifying information regarding the applicant’s date and place of birth; and documentation of the applicant’s charge or convictions.

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Authorizing Statute(s): EO: EO 10467 Name/Subject of EO: Granting Pardon for the Offense of Simple Possession of Marijuana
  

Citations for New Statutory Requirements: EO: EO 10467 Name/Subject of EO: Granting Pardon for the Offense of Simple Possession of Marijuana

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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

Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Application for Certificate of Pardon for Simple Possession of Marijuana	N/A	APPLICATION FOR CERTIFICATE OF PARDON FOR SIMPLE POSSESSION OF MARIJUANA
Application for Pardon Certificate	NA	APPLICATION FOR CERTIFICATE OF PARDON FOR SIMPLE POSSESSION OF MARIJUANA

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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	20,000	20,000	0	20,000	-20,000	0
Annual Time Burden (Hours)	0	40,000	40,000	-40,000	-40,000	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: N/A

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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.     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

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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: 02/08/2023

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