National Crime Information Center (NCIC) Success Capture

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

NCIC Success Capture Form

National Crime Information Center (NCIC) Success Capture

OMB: 1103-0117

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Privacy Act Statement


Authority: The collection of this information is authorized under Title 34 U.S.C. § 10211, 44 U.S.C. § 3101, and the general record keeping provision of the Administrative Procedures Act (5 U.S.C. § 301). Filling out the success story form and providing your contact information is voluntary.


Principal Purpose: The purpose of this form is to gather success stories regarding your use of the National Crime Information Center (NCIC). If provided, your contact information will be used to contact you regarding your submitted success story.


Routine Uses: All success stories will be maintained in accordance with the Privacy Act of 1974. Your success story and your contact information may be disclosed with your consent, and may be disclosed without your consent as permitted by all applicable routine uses as published in the Federal Register (FR), including the routine uses for the FBI Central Records System, JUSTICE/FBI-002, published at 63 FR 8659, 671 (Feb. 20, 1998) and amended at 66 FR 8425 (Jan. 31, 2001), 66 FR 17200 (Mar. 29, 2001) and 82 FR 24147 (May 25, 2017). Routine uses may include sharing information with other federal, territorial, state, local, and tribal criminal justice agencies.



If your success story is selected by our committee as stellar use of the NCIC system, you will receive formal recognition by FBI leadership.

Name


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Agency E-mail Agency Phone


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Agency State


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Estimated Date of Success


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Please briefly share how NCIC assisted you or your agency. Please do not include any Personally Identifiable Information (PII) in your comments. For questions or clarifications, you can reach us at [email protected]



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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorGarman, Chad M. (CJISD) (FBI)
File Modified0000-00-00
File Created2023-08-26

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