Freedom of Information/Privacy Act Record Request Form (INV 100)

Forms and Documents

Document Name	Status
Form INV 100 INV 100 - FREEDOM OF INFORMATION / PRIVACY ACT RECORD REQUEST FORM Form and Instruction	Modified
0705-0001_SSA_08.31.2023.docx Supporting Statement A	2023-08-31
ESD-PIA_0705-0001.pdf Supplementary Document	2023-07-17
SSNJ_Memo_INV 100 (002)-FINAL.docx Supplementary Document	2020-07-14

IC Document Collections

IC ID	Document Title	Status
200701	INV 100 - FREEDOM OF INFORMATION / PRIVACY ACT RECORD REQUEST FORM Form and Instruction	Modified

ICR Details

OMB Control No: 0705-0001	ICR Reference No: 202303-0705-002
Status: Received in OIRA	Previous ICR Reference No: 202007-0705-001
Agency/Subagency: DOD/OUSDI	Agency Tracking No:
Title: Freedom of Information/Privacy Act Record Request Form (INV 100)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/31/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	08/31/2023
Responses	10,097	10,097
Time Burden (Hours)	841	841
Cost Burden (Dollars)	17,670	17,670

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Abstract: form, is an information collection completed by individuals submitting Freedom of Information Act (FOIA), Privacy Act, and Amendment record requests to DCSA’s Freedom of Information and Privacy (FOI/P) Office for Investigations. DCSA’s FOIP Office for Investigations utilizes the Freedom of Information/Privacy Act Records Request for Background Investigations to standardize collection of data elements specific to the types of record requests.

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

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:
	88 FR 23412	04/17/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 56806	08/21/2023
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
INV 100 - FREEDOM OF INFORMATION / PRIVACY ACT RECORD REQUEST FORM	INV 100	FREEDOM OF INFORMATION / PRIVACY ACT RECORDS REQUEST FOR BACKGROUND INVESTIGATIONS

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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	10,097	10,097	0	0	0	0
Annual Time Burden (Hours)	841	841	0	0	0	0
Annual Cost Burden (Dollars)	17,670	17,670	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: $354,404

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: 08/31/2023

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