OMB control number
Form USM-523A, Sequestered Juror Information Form
OMB 1105-0096 ยท DOJ/LA.
OMB 1105-0096
The United States Marshals Service is responsible for ensuring the security of federal courthouses, courtrooms, and federal jurist. The information collected in this form assists Marshals Service personnel in the planning of, and response to, potential security needs of the court and jurors during the course of proceedings.
The latest form for Form USM-523A, Sequestered Juror Information Form expires 2022-03-31 and is listed under ICR 201808-1105-001.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form USM-523A Sequestered Juror Information Form | Form and Instruction |
 Explanation of changes to USM-523A in 2022.docx | Supplementary Document |
| 1105-0096-Supporting-Statement-2026-Renewal.docx | Supporting Statement A |
 Sequestered Juror Information Form |
Form and Instruction |
| Sequestered Juror Information Form |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202504-1105-002 | Reinstatement without change of a previously approved collection | 2026-02-25 | ||
| 202112-1105-001 | Revision of a currently approved collection | 2022-03-21 | Approved without change | |
| 201808-1105-001 | Revision of a currently approved collection | 2018-12-19 | Approved without change | |
| 201510-1105-001 | Revision of a currently approved collection | 2015-10-27 | Approved without change | |
| 201207-1105-003 | New collection (Request for a new OMB Control Number) | 2012-07-24 | Approved without change |