Information Collection

Freedom of Information/Privcy Act Request

IC 21021 under ICR 201703-1615-002 · OMB 1615-0102.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1615-0102 can be found here:

Documents and Forms

Document Name Document Type
Form G-639 Freedom of Information/Privcy Act Request Form
G639-INS-30Day-02282017.pdf Instruction
G-639 Freedom of Information/Privacy Act Request G639-FRM-30Day-02282017.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Freedom of Information/Privcy Act Request	Agency IC Tracking Number:	G-639

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 8 CFR 103

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	G-639	Freedom of Information/Privacy Act Request	G639-FRM-30Day-02282017.pdf		Yes	No	Fillable Printable
Instruction			G639-INS-30Day-02282017.pdf		Yes	No	Printable Only

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: FOIA/PA Records	FR Citation: 79 FR 6609

Number of Respondents: 163,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	163,000	21,000	142,000
Annual IC Time Burden (Hours)	40,750	5,250	35,500
Annual IC Cost Burden (Dollars)	859,450	326,950	532,500

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.