Privacy Act Statement

The collection, maintenance, and disclosure of this information is governed by the Privacy Act (PA) of 1974 (5 U.S.C. § 552a).

AUTHORITY: Freedom of Information Act (FOIA), 5 U.S.C. § 552, and the Privacy Act of 1974, 5 U.S.C.§ 552a, as amended.

PURPOSE: The primary purpose for providing the requested information on this form is to request access to information under the FOIA and/or PA, or amendment or correction of records under the PA. The Department of Commerce (Department) uses the information to grant or deny your request.

ROUTINE USES: The Department will use the information collected to identify records responsive to a FOIA and/or PA request, and to provide copies of records to the requester. The information provided may be disclosed to another agency (a) with interest in the record in connection with a referral of a FOIA request to that agency for its views or decisions on disclosure or (b) to consult with and obtain recommendations concerning matters on which the agency has specialized experience or particular competence that may be useful to Department in making required determinations under the FOIA or (c) to a debt collection agency to collect outstanding debts owed to the Department for fees associated with processing FOIA and combined FOIA and PA requests. Department may also include some information in a publicly available log of FOIA requests.

The information will be maintained, and any disclosures will be made in accordance with the Department’s Privacy Act system of records notice DEPT-5, Freedom of Information Act and Privacy Act Request Records, available at: www.commerce.gov/opog/privacy/SORN/SORN-DEPT-5.

DISCLOSURE: Furnishing the requested information is voluntary; however, failure to provide the requested information may result in a delay or inability of the Department to process your FOIA and combined FOIA and PA requests.