Information Collection

USM-234, District/Aviation Security Officers (DSO/ASO) Personal Qualifications Statement

IC 229796 under ICR 201711-1105-001 · OMB 1105-0104.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0104 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form USM-234 USM-234, District/Aviation Security Officers (DSO/ASO) Personal Qualifications Statement	Form and Instruction
USM-234 District/Aviation Security Officers (DSO/ASO) Personal Q usm234-20171130.pdf	Form and Instruction
New Collection - USM-234 - Supporting Statement.docx Supporting Statement	IC Document

IC Title:

USM-234, District/Aviation Security Officers (DSO/ASO) Personal Qualifications Statement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	USM-234	District/Aviation Security Officers (DSO/ASO) Personal Qualifications Statement	usm234-20171130.pdf		No		Fillable Printable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title: OPM/Govt-1, General Personnel Records

FR Citation: 76 FR 32997

Number of Respondents: 1,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	1,250	1,250
Annual IC Cost Burden (Dollars)	33,380	33,380

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	New Collection - USM-234 - Supporting Statement.docx	01/23/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.