Information Collection

Request for Individual Access to Records Protected Under the Privacy Act

IC 267385 under ICR 202404-1505-001 · OMB 1505-0281.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Request for Individual Access to Records Protected Under the Privacy Act	Form and Instruction
Request for Individual Access to Records Protected under Request for Individual Access Form 2024.pdf	Form and Instruction
Request for Individual Access to Records Protected under Request for Individual Access Form 2024.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

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
Form and Instruction	N/A	Request for Individual Access to Records Protected under the Privacy Act	Request for Individual Access Form 2024.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: Treasury .004 - Freedom of Information Act/Privacy Act Request Records

FR Citation: 81 FR 78266

Number of Respondents: 316

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 New Statute
Annual Number of Responses for this IC	316	316
Annual IC Time Burden (Hours)	79	79
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.