Investigative Request for Employment Data and Supervisory Information, Personal Information, Educational Registrar, and Dean of Students Record Data and Law Enforcement Data
ICR 199810-3206-001
OMB: 3206-0165
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 3206-0165 can be found here:
Investigative Request for
Employment Data and Supervisory Information, Personal Information,
Educational Registrar, and Dean of Students Record Data and Law
Enforcement Data
Extension without change of a currently approved collection
OPM uses these forms to request
information by mail for use in OPM investigations. These
investigations are conducted to determine suitability for Federal
employment and/or the ability to hold a security clearance as
prescribed in Executive Orders 10450, 12968, and 10577.
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.