PRIVACY ACT STATEMENT

AUTHORITY: 10 U.S.C. 5013 Secretary of the Navy; 10 U.S.C. 5041Headquarters, Marine Corps function, composition; 18 U.S.C. 922 Unlawful Acts; 18 U.S.C. 926B and 926C Carrying of concealed firearms by qualified retired law enforcement officers; DoD Instruction 5525.12 Implementation of the Law Enforcement Officers Safety Act of 2004 (LEOSA); and E.O.9397 (SSN), as amended. SORN NM05580-2, Security Incident System: http://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570445/nm05580-2/ PURPOSE: To determine eligibility of requesters and process applications for DON law-enforcement credentials. The applicant's Social Security Number is solicited solely for the purpose of validating identity. ROUTINE USE(S): Information will be disclosed to law enforcement authorities and administrative support staff assigned to the issuing agency with a need to know in order to verify Title 18, Section 926B and 926C eligibility requirements and process applications. Additionally, the answers and any information resulting therefrom may be disclosed for use in a criminal or administrative proceeding if the applicant knowingly and willfully provided false statements or information. DISCLOSURE: Voluntary. However, applicants that fail to provide the requested information will be denied issuance of DON law-enforcement credentials.

OMB CONTROL NUMBER: 0703-0067 OMB EXPIRATION DATE: 10/31/2020 AGENCY DISCLOSURE NOTICE

The public reporting burden for this collection of information is estimated to average 30 minutes 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. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Directives Division, 4800 Mark Center Drive, East Tower, Suite 03F09, Alexandria, VA 22350-3100 0703-0067. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR RESPONSE TO THE ABOVE ADDRESS. Responses should be sent to: Commander, Navy Installations Command, 716 Sicard St, SE, ATTN: James Callahan, LEOSA Program Manager, N3 Anti-Terrorism/Force Protection Branch, Washington Navy Yard, DC 20374-5140, 202-433-9567 Marine Corps: Colonel Zachary M. White, Marine Corps Policy Official, Head, Law Enforcement and Corrections Branch, Security Division, Plans, Policies and Operations (PP&O), Headquarters, U.S. Marine Corps, 3000 Pentagon Room 4A324, Washington, DC 20350-3000, 703-692-4247.