This request for
clearance is approved for use through 6-30-82. Consider using a
National IRS form or OPM Standard Form to collect thi information.
If you decide to resubmit this form provide detailed explanation as
to why you cannot use the National or OPM form.
Inventory as of this Action
Requested
Previously Approved
06/30/1982
06/30/1982
400
0
0
33
0
0
0
0
0
COMPLETE INFORMATION PERTAINING TO AN
APPLICANTS BACKGROUND MUST BE PROVIDED FOR EMPLOYMENT WITH THE
SERVICE CENTER. THIS LETTER IS USED TO REQUEST THAT INFORMATION AND
AS JUSTIFICATION FOR ELIMINATION FROM EMPLOYMENT CONSIDERATION IF
HE OR SHE FAILS TO REPLY. THE INFORMATION IS USED TO DETERMINE
EMPLOYMENT SUITABILITY.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.