Personnel Security Clearance Change Notification

ICR 200404-0704-001

OMB: 0704-0418

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
5509 Migrated
ICR Details
0704-0418 200404-0704-001
Historical Active 200012-0704-002
DOD/DODDEP
Personnel Security Clearance Change Notification
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 06/07/2004
Retrieve Notice of Action (NOA) 04/08/2004
  Inventory as of this Action Requested Previously Approved
06/30/2007 06/30/2007
225,800 0 0
45,160 0 0
0 0 0

The DISCO Form 562 is used by contractors participating in the National Industrial Security Program to report various changes in employee personnel clearance status or identification information, e.g., reinstatements, conversions, terminations, changes in name or other previously submitted information. These requirements are necessary in order to preserve and maintain the security of the United States through establishing standards to prevent the improper disclosure of classified information.

None
None


No

1
IC Title Form No. Form Name
Personnel Security Clearance Change Notification 562

  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 225,800 0 0 225,800 0 0
Annual Time Burden (Hours) 45,160 0 0 45,160 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$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.
04/08/2004


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