US Department of Justice Self Reportable Activities

ICR 202507-1103-001

OMB: 1103-0119

Federal Form Document

Forms and Documents
IC Document Collections
ICR Details
1103-0119 202507-1103-001
Received in OIRA 202203-1103-001
DOJ/DOJADM 1103-0119
US Department of Justice Self Reportable Activities
Reinstatement without change of a previously approved collection   No
Regular 07/07/2025
  Requested Previously Approved
36 Months From Approved
1,550 0
258 0
0 0

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.

None
None

Not associated with rulemaking

  90 FR 18709 05/01/2025
90 FR 29889 07/07/2025
No

1
IC Title Form No. Form Name
US Department of Justice Self Reportable Activities 1103-NEW DOJ Self Reportable Activities

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,550 0 0 0 0 1,550
Annual Time Burden (Hours) 258 0 0 0 0 258
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
    Yes
    Yes
No
No
No
No
Karen Daniels 202 514-2351 karen.daniels@usdoj.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
07/07/2025


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