Information Collection

Application for Pardon After Completion of Sentence

IC 264747 under ICR 202401-1123-002 · OMB 1123-0016.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1123-0016 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Pardon Application.1.22.24 (1123-0NEW).docx	Other-Application
Pardon Application.1.22.24 (1123-0NEW).docx	Other-Application

IC Title:

Application for Pardon After Completion of Sentence

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 28 CFR .35 28 CFR .36 28 CFR 1.1-1.11 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Application			Pardon Application.1.22.24 (1123-0NEW).docx		Yes	Yes	Fillable Printable

Line of Business: Correctional Activities

Subfunction: Criminal Rehabilitation

Privacy Act System of Records

Title: Executive Clemency Case Files/Executive Clemency Tracking System

FR Citation: 82 FR 24151

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	3,000	3,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.