Form DOJ-361 "Certification of Identity"

What Is Form DOJ-361?

Form DOJ-361, Certification of Identity, is a legal document completed by individuals who wish to get access to their Department of Justice records or authorize the release of these records to other individuals. Federal agencies maintain systems of records that collect, maintain, use, and disseminate information about various individuals.

It is forbidden to disclose this information to any other individual or agency without a written request of the individual to whom the record pertains. The Certification of Identity collects personal data sufficient to identify the individual who submits a request and ensures that this individual's records are not wrongfully disclosed without explicit authorization.

This form was released by the U.S. Department of Justice. You can download a DOJ-361 fillable PDF through the link below.

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Form DOJ-361 Instructions

Provide the following information in the DOJ-361 Form:

  1. Write down the full name of the requester - the individual whose records are being sought;
  2. Indicate the requester's citizenship status. To submit such a request, you must be either a U.S. citizen or a permanent resident;
  3. Enter your social security number (SSN). This is voluntary - you may provide your SSN only to facilitate the identification of records that relate to you. Without the SSN, the Department may be unable to locate some of the records that pertain to you;
  4. State your current address, date, and place of birth;
  5. Authorize the release of your Department of Justice records to another person by writing down this individual's full name;
  6. Confirm the information in the form is true and correct, you are the individual named in the request, and you understand the falsification of this document might lead to criminal prosecution;
  7. Sign and date the form.

Once you complete the Certification of Identity, you need to decide where to send your request. Since the Department of Justice has multiple components - bureaus, offices, boards, and divisions, each of them processes its own records to respond to the request contained in the DOJ-361 Form. You may address this form to the component that you believe has the records you wish to be released - Office of the Attorney General, Civil Division, Criminal Division, Drug Enforcement Administration, etc.

However, if you are uncertain about which component has the records, mail the form to the FOIA/PA Mail Referral Unit, Department of Justice, Room 115, LOC Building, Washington, DC 20530-0001. Personnel of the Mail Referral Unit will forward your documentation to the component that is most likely to maintain the sought records.

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Certification of Identity
U.S Department of Justice
FORM APPROVED OMB NO.
1103-0016 EXPIRES 05/31/2020
Privacy Act Statement. In accordance with 28 CFR Section 16.41(d) personal data sufficient to identify the individuals submitting requests by
mail under the Privacy Act of 1974, 5 U.S.C. Section 552a, is required. The purpose of this solicitation is to ensure that the records of individuals
who are the subject of U.S. Department of Justice systems of records are not wrongfully disclosed by the Department.
Requests will not be
processed if this information is not furnished.
False information on this form may subject the requester to criminal penalties under 18 U.S.C.
Section 1001 and/or 5 U.S.C. Section 552a(i)(3).
Public reporting burden for this collection of information is estimated to average 0.50 hours per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Suggestions for reducing this burden may be submitted to the Office of Information and Regulatory Affairs, Office of Management
and Budget, Public Use Reports Project (1103-0016), Washington, DC 20503.
1
Full Name of Requester
________________________________________________________________________
2
3
Citizenship Status
__________________________ Social Security Number
_____________________________
Current Address _______________________________________________________________________________
Date of Birth _______________________________ Place of Birth ______________________________________
OPTIONAL: Authorization to Release Information to Another Person
This form is also to be completed by a requester who is authorizing information relating to himself or herself to be released to another person.
Further, pursuant to 5 U.S.C. Section 552a(b), I authorize the U.S. Department of Justice to release any and all information relating to me to:
Print or Type Name
I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct, and that I am the person
named above, and I understand that any falsification of this statement is punishable under the provisions of 18 U.S.C. Section 1001 by a fine of
not more than $10,000 or by imprisonment of not more than five years or both, and that requesting or obtaining any record(s) under false
pretenses is punishable under the provisions of 5 U.S.C. 552a(i)(3) by a fine of not more than $5,000.
4
Signature
_________________________________________________ Date
_____________________________
1
Name of individual who is the subject of the
record(s)
sought.
2
Individual submitting a request under the Privacy Act of 1974 must be either “a citizen of the United States or an alien lawfully
admitted for permanent residence,” pursuant to 5 U.S.C. Section 552a(a)(2). Requests will be processed as Freedom of Information Act
requests pursuant to 5 U.S.C. Section 552, rather than Privacy Act requests, for individuals who are not United States citizens or aliens
lawfully admitted for permanent residence.
3
Providing your social security number is voluntary. You are asked to provide your social security number only to facilitate the
identification of records relating to you. Without your social security number, the Department may be unable to locate any or all records
pertaining to you.
4
Signature of individual who is the subject of the record sought.
FORM DOJ-361
Certification of Identity
U.S Department of Justice
FORM APPROVED OMB NO.
1103-0016 EXPIRES 05/31/2020
Privacy Act Statement. In accordance with 28 CFR Section 16.41(d) personal data sufficient to identify the individuals submitting requests by
mail under the Privacy Act of 1974, 5 U.S.C. Section 552a, is required. The purpose of this solicitation is to ensure that the records of individuals
who are the subject of U.S. Department of Justice systems of records are not wrongfully disclosed by the Department.
Requests will not be
processed if this information is not furnished.
False information on this form may subject the requester to criminal penalties under 18 U.S.C.
Section 1001 and/or 5 U.S.C. Section 552a(i)(3).
Public reporting burden for this collection of information is estimated to average 0.50 hours per response, including the time for reviewing
instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Suggestions for reducing this burden may be submitted to the Office of Information and Regulatory Affairs, Office of Management
and Budget, Public Use Reports Project (1103-0016), Washington, DC 20503.
1
Full Name of Requester
________________________________________________________________________
2
3
Citizenship Status
__________________________ Social Security Number
_____________________________
Current Address _______________________________________________________________________________
Date of Birth _______________________________ Place of Birth ______________________________________
OPTIONAL: Authorization to Release Information to Another Person
This form is also to be completed by a requester who is authorizing information relating to himself or herself to be released to another person.
Further, pursuant to 5 U.S.C. Section 552a(b), I authorize the U.S. Department of Justice to release any and all information relating to me to:
Print or Type Name
I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct, and that I am the person
named above, and I understand that any falsification of this statement is punishable under the provisions of 18 U.S.C. Section 1001 by a fine of
not more than $10,000 or by imprisonment of not more than five years or both, and that requesting or obtaining any record(s) under false
pretenses is punishable under the provisions of 5 U.S.C. 552a(i)(3) by a fine of not more than $5,000.
4
Signature
_________________________________________________ Date
_____________________________
1
Name of individual who is the subject of the
record(s)
sought.
2
Individual submitting a request under the Privacy Act of 1974 must be either “a citizen of the United States or an alien lawfully
admitted for permanent residence,” pursuant to 5 U.S.C. Section 552a(a)(2). Requests will be processed as Freedom of Information Act
requests pursuant to 5 U.S.C. Section 552, rather than Privacy Act requests, for individuals who are not United States citizens or aliens
lawfully admitted for permanent residence.
3
Providing your social security number is voluntary. You are asked to provide your social security number only to facilitate the
identification of records relating to you. Without your social security number, the Department may be unable to locate any or all records
pertaining to you.
4
Signature of individual who is the subject of the record sought.
FORM DOJ-361