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Federal forms, ICRs, and supporting documents

OMB control number

Certification of Identity

OMB 1103-0016 ยท DOJ/DOJADM.

OMB 1103-0016

This form is used to identity individuals requesting records on self or another individual under the Privacy Act, 5 U.S.C. Section 552a(i)(3) and in accordance with the provisions of 28 C.F.R., Section 16.41(d).

The latest form for Certification of Identity expires 2027-04-30 and is listed under ICR 202401-1103-002.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form DOJ-361 Certification of IdentityForm
1103-0016 Supporting Statement A (2023) + OIP.docxSupporting Statement A
Electronic Code of Federal Regulations Title 28 Judicial Adminstration.pdf Supplementary Document
Certification of Identity Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202401-1103-002 Reinstatement without change of a previously approved collection 2024-01-17 Approved without change
202306-1103-005 Revision of a currently approved collection 2023-06-28 Comment filed on proposed rule and continue
202005-1103-001 Extension without change of a currently approved collection 2020-05-26 Approved without change
201703-1103-001 Extension without change of a currently approved collection 2017-03-09 Approved without change
201310-1103-001 Extension without change of a currently approved collection 2014-01-15 Approved without change
201005-1103-001 Revision of a currently approved collection 2010-10-28 Approved with change
200707-1103-001 Extension without change of a currently approved collection 2007-07-27 Approved without change
200405-1103-002 Revision of a currently approved collection 2004-05-20 Approved without change
200012-1103-002 Revision of a currently approved collection 2000-12-22 Approved without change
199801-1103-003 Reinstatement without change of a previously approved collection 1998-01-12 Approved without change
199411-1103-003 Reinstatement with change of a previously approved collection 1994-11-18 Approved without change
199411-1103-001 Revision of a currently approved collection 1994-11-18 Approved without change