PERSONNEL SECURITY QUESTIONNAIRE (INDUSTRIAL) (MULTI- PURPOSE)

ICR 198204-0704-003

OMB: 0704-0002

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
0704-0002 198204-0704-003
Historical Active 197712-0704-008
DOD/DODDEP
PERSONNEL SECURITY QUESTIONNAIRE (INDUSTRIAL) (MULTI- PURPOSE)
Revision of a currently approved collection   No
Regular
Approved without change 05/04/1982
Retrieve Notice of Action (NOA) 04/05/1982
  Inventory as of this Action Requested Previously Approved
04/30/1985 04/30/1985 12/31/1982
50,000 0 50,000
75,000 0 100,000
0 0 0

TO OBTAIN BACKGROUND INFORMATION FOR PERSONNEL SECURITY INVESTIGATIVE AND EVALUATIVE PURPOSES IN ORDER TO DETERMINE THE SEFCURITY ELIGIBILIT OF DOD CONTRACTOR PERSONNEL FOR ASSIGNMENT TO A SENSITIVE POSITION AND/OR ACCESS TO INFORMATION CLASSIFIED UP TO AND INCLUDING TOP SECRET

None
None


No

1
IC Title Form No. Form Name
PERSONNEL SECURITY QUESTIONNAIRE (INDUSTRIAL) (MULTI- PURPOSE) DD FORM 49

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 50,000 50,000 0 0 0 0
Annual Time Burden (Hours) 75,000 100,000 0 -25,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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.
04/05/1982


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