OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Personal Identity Verification Official (PIV-O) and Shield Request

ICR 202311-1601-002 · OMB 1601-0038 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 11000-16 Personal Identity Verification Official (PIV-O) and Shield Request Form and Instruction New Repair queued
Executive Order 13764.pdf Supplementary Document Uploaded 2023-11-16 Repair queued
Executive Order 13764.pdf Supplementary Document Uploaded 2023-11-16 Repair queued
Supporting Statement A (DHS Form 11000-16)_11.15.2023.docx Supporting Statement A Uploaded 2023-11-16 Missing upstream
60-Day FRN.pdf Supplementary Document Uploaded 2023-11-06 Repair queued
30-Day FRN.pdf Supplementary Document Uploaded 2023-11-06 Repair queued
SORN-DHS All-026 Personal Identity Verification.pdf Supplementary Document Uploaded 2023-11-06 Repair queued
privacy-pia-dhs-all-piv-10-13-2006.pdf Supplementary Document Uploaded 2023-11-06 Repair queued
OMB Form 83-I for DHS Form 11000-16 (v1.0 20230308) (002).pdf Supplementary Document Uploaded 2023-11-06 Repair queued
Homeland Security Presidential Directive 12.pdf Supplementary Document Uploaded 2023-11-06 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
263420 Personal Identity Verification Official (PIV-O) and Shield Request Form and Instruction New
ICR Details
202311-1601-002
Received in OIRA
DHS/OS
Personal Identity Verification Official (PIV-O) and Shield Request
New collection (Request for a new OMB Control Number)   No
Regular 11/16/2023
  Requested Previously Approved
36 Months From Approved
1,500 0
375 0
0 0
This collection of information, using Department of Homeland Security (DHS) Form 11000-16, is necessary to support Homeland Security Presidential Directive 12: Policy for a Common Identification Standard for Federal Employees and Contractors, issued on August 27, 2004, which mandates a federal standard for secure and reliable forms of identification. The collection is used in accordance with System of Record Notice DHS/ALL-026 Department of Homeland Security Personal Identity Verification Management System and Department policy to request a DHS Personal Identity Verification Official (PIV-O) credential, and if applicable, a shield (i.e., metallic law enforcement or non-law enforcement badge) to accompany the credential. A DHS PIV-O credential describes authorities delegated to specific DHS employees, contractors, and affiliates who interact with the public or federal, state, local, or tribal entities to perform authorized official functions pursuant to law, statute, regulation, or DHS Directive.
EO: EO 13764 Name/Subject of EO: Amending the Civil Service rules
   EO: EO 13467 Name/Subject of EO: Reforming Processes Related to Suitability for Government Employment
   EO: EO 9397 Name/Subject of EO: Numbering System for Federal Accounts Relating to Individual Persons
  
None
Not associated with rulemaking
  88 FR 55467 08/15/2023
88 FR 73039 10/24/2023
No
1
IC Title Form No. Form Name
Personal Identity Verification Official (PIV-O) and Shield Request 11000-16 PIV-O Credential and Shield Request
  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 1,500 0 0 0 1,500 0
Annual Time Burden (Hours) 375 0 0 0 375 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a new collection.
$0
No
    Yes
    Yes
No
No
No
No
Jacqueline Thompson 202 796-6292 [email protected]
  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.
11/16/2023