Investigative Forms

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form PD F 5521 Investigative Request For Employment Data and Supervisor Information	Form and Instruction	Modified	Available
Form PD F 5520 Investigative Request For Educational Registrar and Dean of Students Record Data	Form and Instruction	Modified	Available
Form PD F 5519 Investigative Request for Law Enforcement Data	Form and Instruction	Modified	Available
Form PD F 5518 Investigative Request for Personal Information	Form and Instruction	Modified	Available
1535-0141_supporting_statement_20140222.doc	Supporting Statement A	Uploaded 2014-09-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
181471	Investigative Background Forms	Form and Instruction	Modified	Investigative Request For Employment Data and Supervisor Information
181471	Investigative Background Forms	Form and Instruction	Modified	Investigative Request For Educational Registrar and Dean of Students Record Data
181471	Investigative Background Forms	Form and Instruction	Modified	Investigative Request for Law Enforcement Data
181471	Investigative Background Forms	Form and Instruction	Modified	Investigative Request for Personal Information

ICR Details

OMB Control No: 1535-0141	ICR Reference No: 201312-1535-004
Status: Historical Active	Previous ICR Reference No: 201009-1535-001
Agency/Subagency: TREAS/BPD	Agency Tracking No:
Title: Investigative Forms
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/07/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/28/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2017	36 Months From Approved	11/30/2014
Responses	750	0	2,160
Time Burden (Hours)	125	0	361
Cost Burden (Dollars)	0	0	0

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Abstract: Information requested is in support of background investigations conducted by the Bureau of the Fiscal Service

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Authorizing Statute(s): US Code: 5 USC Section 301
   EO: EO 10450 Name/Subject of EO: Security Requirements for Government Employment
   EO: EO 13467 Name/Subject of EO: Reforming Processes Related to Suitability for Government Employment, Fitness for Contractor Employe
   EO: EO 12968 Name/Subject of EO: Access to Classified Information
  

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 63310	10/23/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 10873	02/26/2014
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
Investigative Background Forms	PD F 5521, PD F 5518, PD F 5519, PD F 5520	Investigative Request for Personal Information ,   Investigative Request for Law Enforcement Data ,   Investigative Request For Educational Registrar and Dean of Students Record Data ,   Investigative Request For Employment Data and Supervisor Information

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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	750	2,160	0	0	-1,410	0
Annual Time Burden (Hours)	125	361	0	0	-236	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: Investigation standards were revised by OPM in 2011. The new standards coincided with OPM's introduction of an automated computer check that suffices for the majority of the re-investigations conducted by the Bureau, thus reducing the amount of inquiries sent to contacts listed by the person being investigated.

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Annual Cost to Federal Government: $1,662

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:  No

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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: 02/28/2014

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