Disapproved. Use
of this form after January 1985 is not approved on the grounds that
it imposes an unnecessary burden on the public. Interim use is not
permitted because Standard Forms covering virtually all the
information requested on this form are readily available for
immediate use. Much of the information on this form duplicates
information collected on SF 171, Personnel Qualifications
Statement, which applicants are also required to submit.
Information needed to investigate personal integrity and to provide
information for security clearance can be obtained on SF 172,
Standard Amendment to Personnel Qualifications Statement. The
Department should obtain a kit of these forms from the Office of
Personnel Management. In the unlikely event that information in
addition to that which may b collected on the standard forms is
required prior to employment, a clearance request should be
submitted to this office. duties.
Inventory as of this Action
Requested
Previously Approved
01/22/1985
01/31/1985
0
0
24,500
0
0
12,250
0
0
0
INFORMATION IS GATHERED FROM
PROSPECTIVE CANDIDATES FOR EMPLOYMENT WIT INTERNAL REVENUE SERVICE
CENTER REGARDING FORMER EMPLOYMENT, EDUCATION ARREST RECORD AND
PERSONAL INFORMATION. THIS INFORMATION WI USED TO COMPLETE OTHER
FORMS NECESSARY TO PROCESS A CANDIDATE FOR EMPLOYMENT AS WELL AS
INITIATE INVESTIGATIONS ON THE CANDIDATE'S BACKGROUND.
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.