Information Collection

Personnel Security Investigation Projection for Industry Survey (DSS Form 232)

IC 5507 under ICR 201412-0704-001 · OMB 0704-0417.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0417 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PSI_Projected Requirements Survey_AKA_DSS Form 232.docx	Other-Main Survey
Contact Validation Test Survey.docx	Other-Contact Validation Survey
Contact Validation Invite and 2 Reminders.pdf	Other-Contact Survey Email Invite an
NISPPAC List and Survey Notice.pdf	Other-Main Survey Pre-notification e
Web Posting Notice.docx	Other-Web Posting Notice
DSS Monthly Newsletter.pdf	Other-DSS Newsletter- Example
FSO updates on Projected Requirements Survey.docx	Other-Notice to Facility Security Of

IC Title:

Personnel Security Investigation Projection for Industry Survey (DSS Form 232)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Main Survey	PSI_Projected Requirements Survey_AKA_DSS Form 232.docx	Yes	Yes	Fillable Fileable
Other-Contact Validation Survey	Contact Validation Test Survey.docx	Yes	Yes	Fillable Fileable
Other-Contact Survey Email Invite and Reminders	Contact Validation Invite and 2 Reminders.pdf	Yes	Yes	Fillable Fileable
Other-Main Survey Pre-notification email	NISPPAC List and Survey Notice.pdf	Yes	Yes	Fillable Fileable
Other-Web Posting Notice	Web Posting Notice.docx	Yes	Yes	Fillable Fileable
Other-DSS Newsletter- Example	DSS Monthly Newsletter.pdf	Yes	Yes	Fillable Fileable
Other-Notice to Facility Security Officers	FSO updates on Projected Requirements Survey.docx	Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 13,137

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	13,137	987	12,150
Annual IC Time Burden (Hours)	20,800	4,600	16,200
Annual IC Cost Burden (Dollars)	762,537	229,881	532,656

Documents for IC

table that charts IC Documents
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.