Information Collection

Application for Certificate of Pardon for Simple Possession of Marijuana

IC 258401 under ICR 202303-1123-005 · OMB 1123-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1123-0014 can be found here:

Documents and Forms

Document Name Document Type
Application for Certificate of Pardon for Simple Possession of Marijuana Form and Instruction
APPLICATION FOR CERTIFICATE OF PARDON FOR SIMPLE POSSESS Application for Certificate of Pardon for Simple Marijuana Possession.docx www.justice.gov Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Application for Certificate of Pardon for Simple Possession of Marijuana	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	N/A	APPLICATION FOR CERTIFICATE OF PARDON FOR SIMPLE POSSESSION OF MARIJUANA	Application for Certificate of Pardon for Simple Marijuana Possession.docx	https://www.justice.gov	Yes	Yes	Fillable Printable

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Prosecution and Litigation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Requested	Previously Approved
Annual Number of Responses for this IC	20,000	20,000
Annual IC Time Burden (Hours)	0	0
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.