OMB control number
US Department of Justice Self Reportable Activities
OMB 1103-0119 ยท DOJ/DOJADM.
OMB 1103-0119
Self-reporting requirements per Policy Statement 1700.04 Department Personnel Security Reporting Requirements apply to non-federal employee personnel affiliated with DOJ. The policy contains reporting requirements applicable to entire workforce while additional reporting requirements apply to personnel occupying national security positions or having access to classified information. This request is to receive approval or reporting process (system and forms) for non-federal population.
The latest form for US Department of Justice Self Reportable Activities expires 2027-04-30 and is listed under ICR 202507-1103-001.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 1103-NEW DOJ Self Reportable Activities | Form and Instruction |
| Form 1103-NEW US Department of Justice Self Reportable Activities | Form and Instruction |
| ODAG Approval for OMB #1103-0119.pdf | Supplementary Document |
| ODAG Approval for OMB #1103-0119.pdf | Supplementary Document |
 1103-NEW US Department of Justice Self Reportable Activities 30 Day Notice.htm | Supplementary Document |
| 1103-NEW US Department of Justice Self Reportable Activities 30 Day Notice.htm | Supplementary Document |
 1103-0119 Supporting Statement Part A 2022.docx | Supporting Statement A |
| 1103-0119 Supporting Statement Part A 2022.docx | Supporting Statement A |
 US Department of Justice Self Reportable Activities |
Form and Instruction |
| US Department of Justice Self Reportable Activities |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202507-1103-001 | Reinstatement without change of a previously approved collection | 2025-07-07 | ||
| 202203-1103-001 | Extension without change of a currently approved collection | 2022-03-18 | Approved without change | |
| 201808-1103-001 | New collection (Request for a new OMB Control Number) | 2018-10-29 | Approved without change |