Certification of Identity (Form BC-300)

Forms and Documents

Document Name	Status
Form BC-300 Certification of Identity (Form BC-300) Form	New
Supporting Statement Part A Certification of Identity Form BC-300 12-16-21.docx Supporting Statement A	2021-12-16
Certification of Identity BC-300_30-day FRN Correction Notice.pdf Supplementary Document	2021-12-16
Form BC-300 - 30-day FRN.pdf Supplementary Document	2021-12-08
FORM BC-300_Memo to OMB.pdf Supplementary Document	2021-12-08

IC Document Collections

IC ID	Document Title	Status
250735	Certification of Identity (Form BC-300) Form	New

ICR Details

OMB Control No:	ICR Reference No: 202112-0607-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: DOC/CENSUS	Agency Tracking No:
Title: Certification of Identity (Form BC-300)
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 12/22/2021
Date Submitted to OIRA: 12/16/2021

	Requested	Previously Approved
Expiration Date	6 Months From Approved
Responses	250	0
Time Burden (Hours)	25	0
Cost Burden (Dollars)	0	0

---

Abstract: The information requested on the Certification of Identity (Form BC-300), and the associated evidence, is collected under the Freedom of Information Act (FOIA), 5 U.S.C. § 552, and the Privacy Act of 1974, 5 U.S.C. § 552a. Per 28 C.F.R. §16.41(d), the request for access to records must contain a verification of identity, including the requestor’s full name, current address, and date and place of birth, and be signed under penalty of perjury or notarized. Requests for the release of records will not be processed if the Census Bureau cannot confirm identity based on the information provided. Therefore, this information collection is necessary to prevent unauthorized disclosure of records of individuals maintained by the Census Bureau and allows parties to disclose or release their records to an attorney, accredited representative, qualified organization, or other third party. In order to continue to process Privacy Act requests in a timely manner and ensure that the records of individuals are not wrongfully disclosed, the Census Bureau cannot reasonably comply with the normal clearance procedures.

Emergency Justfication: The need for the Certification of Identity (Form BC-300) is imperative to performing accurate controls of the disbursement of personnel records to the public. This information collection is necessary to prevent unauthorized disclosure of records of individuals maintained by the U.S. Census Bureau, and allows parties who are, or were, in proceedings to disclose or release their records to an attorney, accredited representative, qualified organization, or other third party.

---

Authorizing Statute(s): US Code: 5 USC Section 552 Name of Law: Freedom of Information Act (FOIA)
   US Code: 5 USC Section 552a Name of Law: Privacy Act of 1974
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 69618	12/08/2021
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Certification of Identity (Form BC-300)	BC-300	Certification of Identity

---

ICR Summary of Burden

	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	250	0	0	250	0	0
Annual Time Burden (Hours)	25	0	0	25	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: New information collection request

---

Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 12/16/2021

---