Personnel Security System Access Request Form (PSSAR)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
DMDC - DD2962 Non-substantive Revision Explanation.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-12-28	Available
OMB_XXXX-XXXX_PSSAR_Supporting_Statement(2).DOC	Supporting Statement A	Uploaded 2015-07-31	Available
JPAS_SSN Justification.pdf	Supplementary Document	Uploaded 2015-07-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217732	Personnel Security System Access Request Form (PSSAR)		Modified

ICR Details

OMB Control No: 0704-0542	ICR Reference No: 201612-0704-006
Status: Historical Active	Previous ICR Reference No: 201507-0704-004
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Personnel Security System Access Request Form (PSSAR)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/05/2017
	Date Received in OIRA: 12/29/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2018	09/30/2018	09/30/2018
Responses	44,000	0	44,000
Time Burden (Hours)	7,333	0	7,333
Cost Burden (Dollars)	117,330	0	117,330

---

Abstract: JPAS requires personal data collection to facilitate the initiation, investigation and adjudication of information relevant to DoD security clearances and employment suitability determinations for military, civilian employees and contractors seeking such credentials. Security Managers working in private companies that contract with DoD and require access to JPAS to update security-related information about their company's employees must complete DD Form 2962 to access JPAS. Completion of the form assures users have met the requirements for access to the system of record.

---

Authorizing Statute(s): US Code: 50 USC 401 Name of Law: null
   EO: EO 10450 Name/Subject of EO: null
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 18223	04/03/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 47480	08/07/2015
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Personnel Security System Access Request Form (PSSAR)	Personnel Security System Access Request (PSSAR)

---

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	44,000	44,000	0	0	0	0
Annual Time Burden (Hours)	7,333	7,333	0	0	0	0
Annual Cost Burden (Dollars)	117,330	117,330	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:

---

Annual Cost to Federal Government: $4,400

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

---

Common Form ICR:  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:

(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: 12/29/2016

---