Security

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-1800 can be found here:

Documents and Forms

Document Name Document Type
Form DOE F 471-1 Security Form
OMB 1910-1800 FACTS Visit-Assignment Entry.docx Other-Website
DOE F 471-1 Security Incident Notification Report OMB 1910-1800 DOE F 471.1 Security Incident Notification Report.pdf Form
DOE F 472.3 Foreign Citizenship Ack OMB 1910-1800 DOE F 472.3 Foreign Citizenship Ack.pdf Form
DOE F 473.2 Badge Reqeust OMB 1910-1800 DOE F 473.2 Badge Reqeust.pdf Form
DOe F 473.3 Clearance Access Request OMB 1910-1800 DOE F 473.3 Clearance Access Request.pdf Form
DOE F 5631.18 Security Acknowledgement OMB 1910-1800 DOE F 5631.18 Security Acknowledgement.pdf Form
DOE F 5631.20 Request for Visit OMB 1910-1800 DOE F 5631.20 Request for Visit.pdf Form
DOE F 5631.29 Security Termination OMB 1910-1800 DOE F 5631.29 Security Termination.pdf Form
DOE F 5631.34 Data Report on Spouse Cohabitant OMB 1910-1800 DOE F 5631.34 Data Report on Spouse Cohabitant.pdf Form
DOE F 5631.5 Security Interviews OMB 1910-1800 DOE F 5631.5 Security Interviews.pdf Form
DOE F 5639.3 Report of Security Incident OMB 1910-1800 DOE F 5639.3 Report of Security Incident.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Security	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DOE F 471-1	Security Incident Notification Report	OMB 1910-1800 DOE F 471.1 Security Incident Notification Report.pdf	Yes	Yes	Fillable Fileable
Form	DOE F 472.3	Foreign Citizenship Ack	OMB 1910-1800 DOE F 472.3 Foreign Citizenship Ack.pdf	Yes	Yes	Fillable Fileable Signable
Form	DOE F 473.2	Badge Reqeust	OMB 1910-1800 DOE F 473.2 Badge Reqeust.pdf	Yes	Yes	Paper Only
Form	DOe F 473.3	Clearance Access Request	OMB 1910-1800 DOE F 473.3 Clearance Access Request.pdf	Yes	Yes	Fillable Fileable
Form	DOE F 5631.18	Security Acknowledgement	OMB 1910-1800 DOE F 5631.18 Security Acknowledgement.pdf	Yes	Yes	Fillable Fileable Signable
Form	DOE F 5631.20	Request for Visit	OMB 1910-1800 DOE F 5631.20 Request for Visit.pdf	Yes	Yes	Fillable Fileable
Form	DOE F 5631.29	Security Termination	OMB 1910-1800 DOE F 5631.29 Security Termination.pdf	Yes	Yes	Fillable Fileable Signable
Form	DOE F 5631.34	Data Report on Spouse Cohabitant	OMB 1910-1800 DOE F 5631.34 Data Report on Spouse Cohabitant.pdf	Yes	Yes	Fillable Fileable Signable
Form	DOE F 5631.5	Security Interviews	OMB 1910-1800 DOE F 5631.5 Security Interviews.pdf	Yes	Yes	Fillable Fileable Signable
Form	DOE F 5639.3	Report of Security Incident	OMB 1910-1800 DOE F 5639.3 Report of Security Incident.pdf	Yes	Yes	Fillable Fileable
Other-Website			OMB 1910-1800 FACTS Visit-Assignment Entry.docx	Yes	Yes	Fillable Fileable Signable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 86,893	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 97 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	86,893	0	5,224	81,669
Annual IC Time Burden (Hours)	11,296	0	-59,910	71,206
Annual IC Cost Burden (Dollars)	1,338,390	1,338,390	0	0

Documents for IC

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.