OMB control number
Certification of Identity and Consent Form
OMB 1024-0280 · DOI/NPS.
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 is listed under ICR 201911-1024-001.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 10-945 Certification of Identity and Consent | Form and Instruction |
| 1024-0280 ID and Consent SSA_11.3.2022.docx (document unavailable) | 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All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202209-1024-007 | Extension without change of a currently approved collection | 2023-01-30 | Approved without change | |
| 201911-1024-001 | Extension without change of a currently approved collection | 2020-01-09 | Approved without change | |
| 201610-1024-001 | Existing collection in use without an OMB Control Number | 2016-10-26 | Approved without change |