SF 85 Questionnaire for Non-Sensitive Positions

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form SF 85 SF 85 Questionnaire for Non-Sensitive Positions	Form and Instruction	New	Available
Form SF 85 SF 85 Questionnaire for Non-Sensitive Positions	Form and Instruction	Modified	Available
Copy of SF 85--Adjudication of Comments Received From 60 Day FRN (Published 6-30-17) Spreadsheet FINAL--12-2017.xlsm	Supplementary Document	Uploaded 2017-12-29	Available
2016-24507.pdf	Supplementary Document	Uploaded 2017-12-29	Available
SF 85-Supporting Statement v. 7.doc	Supporting Statement A	Uploaded 2017-12-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
229617	SF 85 Questionnaire for Non-Sensitive Positions	Form and Instruction	New
207780	SF 85 Questionnaire for Non-Sensitive Positions	Form and Instruction	Modified

ICR Details

OMB Control No: 3206-0261	ICR Reference No: 201712-3206-019
Status: Active	Previous ICR Reference No: 201611-3206-004
Agency/Subagency: OPM	Agency Tracking No: SF 85
Title: SF 85 Questionnaire for Non-Sensitive Positions
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/19/2018
	Date Received in OIRA: 12/29/2017
Terms of Clearance: This collection is approved based on the revised materials provided by the Agency.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	36 Months From Approved	09/30/2018
Responses	110,080	0	55,040
Time Burden (Hours)	137,600	0	27,520
Cost Burden (Dollars)	0	0	0

---

Abstract: The SF 85 is completed by civilian employees of the Federal Government, military personnel, and non-federal employees, including Federal contractors and individuals otherwise not directly employed by the Federal Government but who perform work for or on behalf of the Federal Government. For applicants, the SF 85 is to be used only after a conditional offer of employment has been made. The collection is used as the basis of information by the Federal Government in conducting background investigations, of persons under consideration for non-sensitive positions and by agencies in determining whether a person performing work for or on behalf of the Federal Government under a contract should be deemed eligible for logical or physical access.

---

Authorizing Statute(s): EO: EO 10450 Name/Subject of EO: Security requirements for Government employment
  

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:
	82 FR 125	06/30/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 249	12/29/2017
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
SF 85 Questionnaire for Non-Sensitive Positions	SF 85	Questionnaire for Non Sensitive Positions
SF 85 Questionnaire for Non-Sensitive Positions	SF 85, SF 85	Questionnaire for Non Sensitive Positions ,   Questionnaire for Non Sensitive Positions

---

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	110,080	55,040	0	55,040	0	0
Annual Time Burden (Hours)	137,600	27,520	0	110,080	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The questions represent an effort to obtain as much relevant and required information as possible directly from the person to be investigated, in accordance with provisions of the Privacy Act.

---

Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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:  Yes

OIRA authorizes any Agency to begin using a Common Form associated with this ICR automatically after 15 calendar days from the date the agency's RCF including the common form was received in OIRA.

Description/Changes for Common Form Usage:  The Privacy Act Statement, Public Burden Statement and upon initiation, the respondent’s previously entered data (except ‘yes/no’ questions) will populate a new investigative request and the respondent will be allowed to update his or her information and certify the data.

Approved RCFs using this ICR

table that charts list of RCF

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title
CFPB	201809-3170-001CF	CFPB's use of SF-85 Questionnaire for Non-Sensitive Positions	Active	SF 85 Questionnaire for Non-Sensitive Positions

---

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: 12/29/2017

---