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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.