Personal Identity Verification Official (PIV-O) and Shield Request

Documents and Forms

Document Name Document Type
Form 11000-16 Personal Identity Verification Official (PIV-O) and Shield Request Form and Instruction
11000-16 PIV-O Credential and Shield Request DHS11000-16-DHS PIV-O Credential and Shield Request-03062023 (clean).pdf Form and Instruction
11000-16 PIV-O Credential and Shield Request DHS11000-16-DHS PIV-O Credential and Shield Request-03062023 (clean).pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Personal Identity Verification Official (PIV-O) and Shield Request	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

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	11000-16	PIV-O Credential and Shield Request	DHS11000-16-DHS PIV-O Credential and Shield Request-03062023 (clean).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records
Title: PIV Management System System of Records	FR Citation: 74 FR 30301

Number of Respondents: 1,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1,500	1,500
Annual IC Time Burden (Hours)	375	375
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.