Memorandum

MEMORANDUM TO: Robert Houser

Department Clearance Officer

United States Department of Justice

FROM: Joey L. Hixenbaugh

Section Chief

Biometric Services Section

Federal Bureau of Investigation

SUBJECT: Revision of an existing approved collection (OMB 1110-0069)

Attached is the information collection request (ICR), Flash/Cancellation/Transfer Notice (I-12) for approval and submission to the Office of Management and Budget (OMB). The requirements of this collection are proscribed by Title 28, U.S. Code, Section 534. These forms are the means by which federal, state, and local law enforcement indicate on an individual's identity history that the individual is being supervised to ensure the supervisory agency is notified of any additional criminal activity, or to indicate the individual was transferred to another agency. The following documents are contained in this ICR package:

1. Supporting Statement for Paperwork Reduction Act Submission with burden statement

2. Law or authority mandating the information collection

3. Certification Statement

4. OMB form 83-I Paperwork Reduction Act Submission

5. Form used to collect the information

6. 60-day ICR notice that will be published in the Federal Register

7. 30-day ICR notice that will be published in the Federal Register

If there are any questions concerning this ICR, please contact Marissa N. Pasquale, Federal Bureau of Investigation, Criminal Justice Information Services Division, Biometric Services Section, Module E-1, 1000 Custer Hollow Road, Clarksburg, West Virginia 26306; or by telephone (304) 625-4320, or email <Gerry.brovey@fbi.gov>.

Thank you