Certification of Identity for Freedom of Information and Privacy Act Requests

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form FDA 3975 Certification of Identify	Form and Instruction	Modified	Available
0910-0832_Supporting Statement A_2026.docx	Supporting Statement A	Uploaded 2026-06-30	Available
0832_Comment 2.pdf	Public Comments	Uploaded 2026-06-30	Available
0832_Comment 1.pdf	Public Comments	Uploaded 2026-06-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226535	Certification of Identity; Form FDA 3975	Form and Instruction	Modified	Certification of Identify

ICR Details

OMB Control No: 0910-0832	ICR Reference No: 202606-0910-001
Status: Received in OIRA	Previous ICR Reference No: 202210-0910-005
Agency/Subagency: HHS/FDA	Agency Tracking No: OII
Title: Certification of Identity for Freedom of Information and Privacy Act Requests
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/30/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2026
Responses	24	24
Time Burden (Hours)	12	4
Cost Burden (Dollars)	0	0

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Abstract: In processing certain requests under the Freedom of Information Act (FOIA) and the Privacy Act, the agency must confirm that the individual making the request is the same person to whom the records pertain and will be released. Form FDA 3975 entitled “Certification of Identity” is used by FDA to identify an individual requesting a particular record under the FOIA and the Privacy Act. The form is required only if an individual makes a FOIA or Privacy Act request for their own records but has not provided sufficient assurance of identity in the incoming request.

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Authorizing Statute(s): US Code: 5 USC 552a Name of Law: Privacy Act
   US Code: 5 USC 552 Name of Law: Freedom of Information Act
  

Citations for New Statutory Requirements: US Code: 5 USC 552 Name of Law: Freedom of Information Act
US Code: 5 USC 552a Name of Law: Privacy Act

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 30944	07/11/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 37410	06/23/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Certification of Identity; Form FDA 3975	FDA 3975	Certification of Identify

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ICR Summary of Burden

table that charts list of burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	24	24	0	0	0	0
Annual Time Burden (Hours)	12	4	0	0	8	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There are no changes to the information collection. ROCIS reflects an increase in burden hours; however, this increase does not represent a programmatic change. During the previous renewal, the estimated burden per response was inadvertently reported as 0.17 hours instead of 0.5 hours. This submission corrects that error and the resulting increase in total annual burden hours is solely attributable to the correction of the previously reported burden estimate.

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Annual Cost to Federal Government: $1,217

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/30/2026

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