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Security
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OMB: 1910-1800
IC ID: 23402
OMB.report
DOE/DOEOA
OMB 1910-1800
ICR 200809-1910-004
IC 23402
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-1800 can be found here:
2023-08-10 - Revision of a currently approved collection
2021-10-29 - Extension without change of a currently approved collection
Documents and Forms
Document Name
Document Type
Form DOE-F-5639.3
Security
Form
DOE F 472.1 Fair Credit Reporting Act Authorization
DOE F 472 1.pdf
Form and Instruction
DOE F 5631.5 The Conduct of Personnel Security Interviews Under DOE S
DOE F 5631 5.pdf
Form and Instruction
DOE F 5631.18 Security Acknowledgement
DOE F 5631 18.pdf
Form
DOE F 5631.29 Security Termination Statement
DOE F 5631 29.pdf
Form
DOE-F-5639.3 US Department of Energy Report of Security Incident/Infr
5639-3.pdf
Form
DOE-F-5631.34 US Department of Energy Data Report on Spouse/Cohabitant
doe f 5631.34.pdf
Form
DOE/NRC-F-740M US Department of Energy and US Nuclear Regulatory Commis
nrc740m.pdf
Form
DOE/NRC-F-742C US Department of Energy and US Nuclear Regulatory Commis
NRC_742C.pdf
Form
DOE/NRC-F-741 US Department of Energy and US Nuclear Regulatory Commis
741.pdf
Form
DOE/NRC-F-742 US Department of Energy and US Nuclear Regulatory Commis
doe-nrc f742.pdf
Form
DOE/NRC-F-749 US Department of Energy ADP Transcription Sheet Internal
749.pdf
Form
SF-328 Certificate Pertaining to Foreign Interests
sf328.pdf
Form
DOE-F-471.1 US Department of Energy Office of Safeguards and Securit
471-1.pdf
Form
DOE F 5631.20 US Department of Energy Request for Visit or Access Appr
5631_20outside.pdf
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Security
Agency IC Tracking Number:
Kathy Murphy
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
DOE-F-5639.3
US Department of Energy Report of Security Incident/Infraction
5639-3.pdf
Yes
Yes
Fillable Printable
Form
DOE-F-5631.34
US Department of Energy Data Report on Spouse/Cohabitant
doe f 5631.34.pdf
Yes
Yes
Fillable Printable
Form
DOE/NRC-F-740M
US Department of Energy and US Nuclear Regulatory Commission Concise Note
nrc740m.pdf
Yes
Yes
Fillable Printable
Form
DOE/NRC-F-742C
US Department of Energy and US Nuclear Regulatory Commission Physical Inventory Listing
NRC_742C.pdf
Yes
No
Fillable Printable
Form
DOE/NRC-F-741
US Department of Energy and US Nuclear Regulatory Commission Nuclear Material Transaction Report
741.pdf
Yes
Yes
Fillable Printable
Form
DOE/NRC-F-742
US Department of Energy and US Nuclear Regulatory Commission Material Balance Report
doe-nrc f742.pdf
Yes
No
Fillable Printable
Form
DOE/NRC-F-749
US Department of Energy ADP Transcription Sheet Internal Project Transfers
749.pdf
Yes
Yes
Fillable Printable
Form
SF-328
Certificate Pertaining to Foreign Interests
sf328.pdf
Yes
Yes
Fillable Printable
Form
DOE-F-471.1
US Department of Energy Office of Safeguards and Security Security Incident Notification Report
471-1.pdf
Yes
Yes
Fillable Printable
Form
DOE F 5631.20
US Department of Energy Request for Visit or Access Approval
5631_20outside.pdf
Yes
No
Fillable Printable
Form and Instruction
DOE F 5631.5
The Conduct of Personnel Security Interviews Under DOE Security Regulations
DOE F 5631 5.pdf
Yes
No
Printable Only
Form
DOE F 5631.18
Security Acknowledgement
DOE F 5631 18.pdf
Yes
No
Fillable Fileable Signable
Form
DOE F 5631.29
Security Termination Statement
DOE F 5631 29.pdf
Yes
No
Fillable Fileable Signable
Form and Instruction
DOE F 472.1
Fair Credit Reporting Act Authorization
DOE F 472 1.pdf
Yes
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
International Affairs and Commerce
Subfunction:
Foreign Affairs
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
96,968
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
97 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
121,637
0
57,796
0
0
63,841
Annual IC Time Burden (Hours)
264,023
0
14,068
0
0
249,955
Annual IC Cost Burden (Dollars)
0
0
0
0
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.