Form 9014_June 2011

LOCATION	CURRENT VERSION	PROPOSED CHANGE	JUSTIFICATION
Top of Form	CIKR Sector Clearance Program Request	Critical Infrastructure Private Sector Clearance Program Request	Updated Name of Program
Top left	“Full Name”	“Full Legal Name”	To more clearly articulate the information being requested
Upper right	Sector: type in field	Sector: Drop down menu	To restrict the applicant’s entry to the appropriate Critical Infrastructure sectors
Upper right	Degree of Clearance	Level of Clearance	Use of more widely used terminology
Background Information/ Justification section	Subjects responsibilities….	Subject’s responsibilities…..	Add apostrophe for proper grammer
Background Information/ Justification section	Subject’s positions require….. involving the (type in sector)	Add drop down menu for sector	To restrict the applicant’s entry to the appropriate Critical Infrastructure sectors
Bottom of Justification section	Provide the following information if you previously held or currently hold a clearance	Provide all of the below requested information ONLY if you previously held an active clearance within the last 24 months	More accurately describe the information needed
Signatures section	NOMINATOR	NOMINATOR: PSA, IP SS, SSA	Identify the appropriate nominators
Signatures section	DIVISION DIRECTOR, POD:	A/S FOR INFRASTRUCTURE PROTECTION	Programmatic change to identify the Assistant Secretary for Infrastructure Protection as the final approver for clearance nominations
Privacy Act Statement	Section 201 of the Homeland Security Act; Executive Order 12958 (as amended by Executive Order13292); and Executive Order 12968 authorizes the collection of this information	Authority: Section 201 of the Homeland Security Act; Executive Orders 12968, 13526, and 13549 authorize the collection of this information.	Updated to reflect new Executive Orders (13526 replaced 12958 and 13549 is the new E.O. for State, Local, Tribal, Private Sector Security Programs)

OMB 83C FOR DHS FORM 9014, DHS/NPPD/IP CRITICAL INFRASTRUCTURE PRIVATE SECTOR CLEARANCE PROGRAM