Collection of Required Data Elements to Verify Eligibility

ICR 201512-0704-004

OMB: 0704-0545

Federal Form Document

Forms and Documents
Document
Name
Status
Justification for No Material/Nonsubstantive Change
2015-12-11
Justification for No Material/Nonsubstantive Change
2015-12-11
Supplementary Document
2015-11-04
Supplementary Document
2015-11-04
Supplementary Document
2015-10-28
Supplementary Document
2015-10-14
Supplementary Document
2015-10-14
Supporting Statement A
2015-10-14
ICR Details
0704-0545 201512-0704-004
Historical Active 201510-0704-002
DOD/DODDEP
Collection of Required Data Elements to Verify Eligibility
No material or nonsubstantive change to a currently approved collection   No
Emergency 11/16/2015
Approved with change 12/11/2015
Retrieve Notice of Action (NOA) 12/11/2015
The collection is approved based on the materials provided by the Department.
  Inventory as of this Action Requested Previously Approved
05/31/2016 05/31/2016 05/31/2016
19,000,000 0 19,000,000
2,650,000 0 2,650,000
111,299,997 0 111,299,997

This is a new collection of information necessitated by the Office of Personnel Management (OPM) cybersecurity incident in which approximately 21.5 million security clearance background investigation records containing personally identifying information (PII) were compromised. The information collected will be used only to verify whether or not an individual was impacted by the OPM cybersecurity incident involving background investigation records and to send a letter confirming status as “impacted” or “not impacted” by this incident.
The information collection is being initiated at this time due to the immediate need to provide assurance and awareness to all impacted individuals and their minor children. The information collected will be used only to verify whether or not an individual was impacted by the OPM cybersecurity incident. If the individual is categorized as “impacted,” they will receive Government-provided identity protection and credit monitoring services. We, therefore, are asking for emergency consideration in order to implement this collection as soon as possible to provide individuals with immediate safeguards and to further protect US government interests within information security and integrity.

None
None

Not associated with rulemaking

80 FR 61796 10/14/2015
No

1
IC Title Form No. Form Name
Collection of Required Data Elements to Verify Eligibility

  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 19,000,000 19,000,000 0 0 0 0
Annual Time Burden (Hours) 2,650,000 2,650,000 0 0 0 0
Annual Cost Burden (Dollars) 111,299,997 111,299,997 0 0 0 0
No
No

$15,042,000
No
No
No
No
No
Uncollected
Frederick Licari 571 372-0493 [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.
12/11/2015


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