Certification of Identity and Consent Form

OMB 1024-0280

The purpose of the collection is to enable the NPS to locate applicable records and to respond to requests made under the Freedom of Information Act and the Privacy Act of 1974. Information includes sufficient personally identifiable information and/or source documents as applicable. The detailed personal information, to include the date/place of birth, as well as the requestor’s Social Security Number, is needed to identify records unique to the requestor. Failure to provide the required information may result in the NPS being unable to take any action on the request.

The latest form for Certification of Identity and Consent Form expires 2023-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 10-945 Certification of Identity and Consent Form and Instruction
1024-0280 ID and Consent SSA_11.3.2022.docx Supporting Statement A
Privacy Act Files – Interior, DOI-57.pdf Supplementary Document
Electronic FOIA Tracking System and FOIA Case Files – Interior, DOI-71.pdf Supplementary Document
Incident Management, Analysis and Reporting System.pdf Supplementary Document
1024-0280 ID and Consent_88FR5908_2023-0130.pdf Supplementary Document
1024-0280 ID and Consent 60-day FRN 3-28-2022 87 FR 17321.pdf Supplementary Document
54 USC 100101 NPS Organic Act.pdf Supplementary Document
Privacy Act of 1974 5 USC §552a.pdf Supplementary Document
Freedom of Information Act 5 USC §552.pdf Supplementary Document
Certification of Identity and Consent Form and Instruction

All Historical Document Collections

202209-1024-007 Approved without change	Extension without change of a currently approved collection	2023-01-30
201911-1024-001 Approved without change	Extension without change of a currently approved collection	2020-01-09
201610-1024-001 Approved without change	Existing collection in use without an OMB Control Number	2016-10-26