DOI Access & Consent Forms

OMB 1093-0013

OMB 1093-0013

Latest Forms, Documents, and Supporting Material

Document Name
Form DI-4017 DI-4017, Consent for Disclosure of Records Protected under the Privacy Act Form and Instruction
Form DI-4016 DI-4016, Request for Individual Access to Records Protected under the Privacy Act, Form and Instruction
1093-0013 Published 30 Day Notice - 91 FR 718 - 01082026.pdf Supplementary Document
1093-0013 - Supporting Statement A (508)_Access and Consent Forms 12182025.docx Supporting Statement A
1093-0013 Published 60 Day Notice - 90 FR 17950 - 04302025.pdf Supplementary Document
SORN - FWS 5.pdf Supplementary Document
M-21-04.pdf Supplementary Document
PLAW-116publ50.pdf Supplementary Document
DI-4017, Consent for Disclosure of Records Protected under the Privacy Act Form and Instruction
DI-4016, Request for Individual Access to Records Protected under the Privacy Act, Form and Instruction

All Historical Document Collections

202504-1093-001	Extension without change of a currently approved collection	2026-01-08
202210-1093-001 Approved with change	Existing collection in use without an OMB Control Number	2022-10-21

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