United States Park Police Personal History Statement

ICR 201010-1024-001

OMB: 1024-0245

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supplementary Document
2010-10-27
Supporting Statement A
2010-10-26
Supplementary Document
2010-10-15
Supplementary Document
2010-10-15
IC Document Collections
ICR Details
1024-0245 201010-1024-001
Historical Active 200706-1024-001
DOI/NPS
United States Park Police Personal History Statement
Revision of a currently approved collection   No
Regular
Approved without change 01/20/2011
Retrieve Notice of Action (NOA) 10/28/2010
  Inventory as of this Action Requested Previously Approved
01/31/2014 36 Months From Approved 01/31/2011
1,000 0 600
8,000 0 4,800
11,100 0 0

The information received will be used principally as a basis for an investigation to determine an applicant's fitness for employment purposes, including a security clearance, an evaluation of qualifications, suitability, and loyalty to the United States.

US Code: 5 USC Sec.'s 1302, 1304 & 3301 Name of Law: Administrative Procedures Act
   EO: EO 10450 Name/Subject of EO: Security Requirements for Government Employees
   US Code: 42 USC Section 2455 Name of Law: Public Health and Welfare - Security Requirements
  
None

Not associated with rulemaking

  75 FR 27574 05/17/2010
75 FR 66121 10/27/2010
No

1
IC Title Form No. Form Name
US Park Police Personal History Statement USPP Form 1 United States Park Police Personal History Statement

  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 1,000 600 0 0 400 0
Annual Time Burden (Hours) 8,000 4,800 0 0 3,200 0
Annual Cost Burden (Dollars) 11,100 0 0 11,100 0 0
No
No
We are estimating 1,000 annual responses and 8,000 burden hours for this collection, which is an adjustment increase of 400 responses and 3,200 burden hours. We increased the number of responses based on our experience in administering this collection. We are reporting as a program change, $11,100 for printing and notarization costs as explained in item 13 of the supporting statement. Printing costs were not applicable in previous submissions because the form was provided as a hard copy. However, the requirement to have the form notarized has always been required, but we have not previously included this cost.

$24,560
No
No
No
No
No
Uncollected
Robert Gordon 202 354-1936 [email protected]

  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.
10/28/2010


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