Information Collection

Personnel Security Clearance Change Notification

IC 5509 under ICR 200712-0704-005 · OMB 0704-0418.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0418 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DISCO Form 562 Personnel Security Clearance Change Notification	Form
DISCO Form 562 Personnel Security Clearance Change Notification DISCO_Form_562.pdf	Form

IC Title:

Personnel Security Clearance Change Notification

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DISCO Form 562	Personnel Security Clearance Change Notification	DISCO_Form_562.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: V5-05 Joint Personnel Adjudication System (JPAS)

FR Citation: 70 FR 38120

Number of Respondents: 11,290

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 93 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	225,800	225,800
Annual IC Time Burden (Hours)	45,160	45,160
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.