Certification of Identity for Freedom of Information and Privacy Act Requests

OMB 0910-0832

This information collection supports laws pertaining to the Freedom of Information Act (5 USC 552 (FOIA)) and the Privacy Act (5 USC 552a), as well as applicable FDA regulations at 21 CFR Part 20 and Part 21. In processing certain requests under the FOIA and the Privacy Act, the agency must confirm that the individual making the request is the same person to whom the records pertain and will be released.

The latest form for Certification of Identity for Freedom of Information and Privacy Act Requests expires 2023-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form FDA 3975 Certification of Identity; Form FDA 3975 Form and Instruction
0832 SSA 2023 4-28-23clean.docx Supporting Statement A
Certification of Identity; Form FDA 3975 Form and Instruction

All Historical Document Collections

202210-0910-005 Approved without change	Extension without change of a currently approved collection	2023-05-03
202005-0910-001 Approved without change	Extension without change of a currently approved collection	2020-05-11
201704-0910-012 Approved without change	New collection (Request for a new OMB Control Number)	2017-04-28