SF 85 Questionnaire for Non-Sensitive Positions

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SF 85 SF 85 Questionnaire for Non-Sensitive Positions	Form and Instruction	New	Available
2013-23833.pdf	Supplementary Document	Uploaded 2013-09-30	Available
SF 85 Supporting Statement.doc	Supporting Statement A	Uploaded 2013-09-30	Available
Sf 85 60 Day FRN, Vol. 78, No. 138, Thursday, July 18, 2013, Pages 42982-42983.pdf	Supplementary Document	Uploaded 2013-08-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
207780	SF 85 Questionnaire for Non-Sensitive Positions	Form and Instruction	New

ICR Details

OMB Control No: 3206-0261	ICR Reference No: 201307-3206-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: OPM	Agency Tracking No:
Title: SF 85 Questionnaire for Non-Sensitive Positions
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/04/2013
	Date Received in OIRA: 09/30/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	36 Months From Approved
Responses	55,040	0	0
Time Burden (Hours)	27,520	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This NEW package, unbundled from the SF 86 (OMB 3206-0005) transmits a 30 Day Notice request for clearance for the Federal Register publication notice of a request for review of the SF 85. The SF 85 is completed by civilian employees of the Federal Government, military personnel, and non-federal employees, including Federal contractors and individuals otherwise not directly employed by the Federal Government but who perform work for or on behalf of the Federal Government. For applicants, the SF 85 is to be used only after a conditional offer of employment has been made. The collection is used as the basis of information by the Federal Government in conducting background investigations, of persons under consideration for non-sensitive positions and by agencies in determining whether a person performing work for or on behalf of the Federal Government under a contract should be deemed eligible for logical or physical access.

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Authorizing Statute(s): EO: EO 10450 Name/Subject of EO: Security requirements for Government employment
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 42982	07/18/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 59983	09/30/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
SF 85 Questionnaire for Non-Sensitive Positions	SF 85	Questionnaire for Non-Sensitive Positions

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ICR Summary of Burden

table that charts list of burden

	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	55,040	0	0	55,040	0	0
Annual Time Burden (Hours)	27,520	0	0	27,520	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The SF 85 has been split from its previous ICR package, 3206-0005. As a result, its burden us being separately calculated.

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title
CFPB	201404-3170-003CF	CFPB's use of SF-85 Questionnaire for Non-Sensitive Positions	Historical Active	SF 85 Questionnaire for Non-Sensitive Positions

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/30/2013

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