NCUA Personnel Security Processing Forms

Forms and Documents

Document Name	Status
Form 1092 Personnel Security Data Form- Employee Form	New
Form 1093 Credit Release Form	New
Form 1092C Personnel Security Data Form- Contractor Form	New
Emergency Justification Memo Final_Signed.docx.pdf Justification for No Material/Nonsubstantive Change	2019-06-12
FINAL_3133-NEW_SS_Persec (Contractor Data Forms)_061219.docx Supporting Statement A	2019-06-12

IC Document Collections

IC ID	Document Title	Status
236447	Personnel Security Data Form- Employee Form	New
236446	Credit Release Form	New
236445	Personnel Security Data Form- Contractor Form	New

ICR Details

OMB Control No: 3133-0201	ICR Reference No: 201906-3133-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: NCUA	Agency Tracking No:
Title: NCUA Personnel Security Processing Forms
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 06/14/2019
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/13/2019
	Date Received in OIRA: 06/12/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	3 Months From Approved
Responses	1,200	0	0
Time Burden (Hours)	200	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: Title 5, Code of Federal Regulations, Part 731 (suitability), Executive Order (E.O.) 13764 (contractor fitness), E.O. 12968/SEAD 4 (classified access), and Homeland Security Directive-12 (badging) requires all federal and contractor employees to undergo a background investigation when seeking employment with an agency. The NCUA Personnel Security Processing Forms (Personnel Security Data Form-Contractor, Personnel Security Data Form-Employee and the Authorization for Release of Credit Information) are used to collect information necessary for applying the government-established suitability/fitness criteria on employees before they can begin employment with or perform contractual services for the NCUA. It may be also required should a contract employee be moved to a new contract work. The background investigation process culminates in an adjudicative determination on whether or not these employees are fit to perform services on behalf of the agency.

Emergency Justfication: In accordance with the Paperwork Reduction Act, the National Credit Union Administration (NCUA) requests emergency consideration of the information collection requirements for its personnel security forms: Personnel Security Data Form-Contractor; Personnel Security Data Form-Employee; and, Authorization for Release of Credit Information (jointly referred to as the Personnel Security forms). The NCUA routinely hires federal and contract employees (jointly referred to as employees) to meet the agency’s mission of regulating and supervising the nation’s credit union system. As part of its hiring process, NCUA requires that all employees undergo a background investigation and subsequent determination pursuant to 5 CFR Part 731 (suitability), Executive Order (E.O.) 13764 (contractor fitness), and E.O. 12968/SEAD 4 (classified access). The pre-employment background checks and adjudicative determination are used to determine whether these employees are qualified to carry out the duties with appropriate integrity, efficiency, and effectiveness. The information collected on these forms is not duplicative of information otherwise collected and is not readily available to NCUA from another source. Information collected on the Personnel Security forms include personally identifiable information such as employee name, position or contract data, and contact information. NCUA primarily uses this information to initiate components of the required background investigation through the investigation service provider (currently the Office of Personnel Management), Federal Bureau of Investigation, and the Department of Homeland Security. These forms may also be used to facilitate detail assignments, contract transition, or promotions. In order to ensure compliance under the PRA and to avoid substantial delays in the onboarding processing of employees which could impact the safety and efficiency of the NCUA, please accept this submission for emergency consideration.

---

Authorizing Statute(s): EO: EO 13764 Name/Subject of EO: Contractor fitness
   EO: EO 12968 Name/Subject of EO: Classified Access
  

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

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Credit Release	1093	Credit Release
Personnel Security Data Form- Employee	1092	Personnel Security Data Form- Employee
Personnel Security Data Form- Contractor	1092C	Personnel Security Data Form- Contractor

---

ICR Summary 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	1,200	0	0	1,200	0	0
Annual Time Burden (Hours)	200	0	0	200	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: This is a new information collection.

---

Annual Cost to Federal Government: $434,825

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:  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: 06/12/2019

---