National Park Service Background Clearance Initiation Request

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 10-152 Background Clearance Initiation Request	Form and Instruction	Modified	Available
Federal Register, Volume 72 FR11036 (DOI-45).pdf	Supplementary Document	Uploaded 2019-12-13	Available
1024-0282 30 day FRN (published).pdf	Supplementary Document	Uploaded 2020-01-30	Available
1024-0282 SSA.Background Initiation Request Form.12.13.2019.docx	Supporting Statement A	Uploaded 2019-12-13	Available
1024-0282 60 day FRN (published).pdf	Supplementary Document	Uploaded 2019-12-09	Available
EO 10450--Security requirements for Government employment.pdf	Supplementary Document	Uploaded 2019-12-09	Available
EO 10577--Amending the Civil Service Rules and authorizing a new appointment system for t.pdf	Supplementary Document	Uploaded 2019-12-09	Available
5 USC 9101 Criminal history record information for national security purposes.pdf	Supplementary Document	Uploaded 2019-12-09	Available
5 USC 3302 Competitive service; rules.pdf	Supplementary Document	Uploaded 2019-12-09	Available
5 USC 3301 Civil service; generally.pdf	Supplementary Document	Uploaded 2019-12-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
223393	Background Clearance Initiation Request	Form and Instruction	Modified

ICR Details

OMB Control No: 1024-0282	ICR Reference No: 201912-1024-003
Status: Active	Previous ICR Reference No: 201609-1024-002
Agency/Subagency: DOI/NPS	Agency Tracking No:
Title: National Park Service Background Clearance Initiation Request
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/29/2020
	Date Received in OIRA: 01/30/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2023	36 Months From Approved	10/31/2020
Responses	6,500	0	6,500
Time Burden (Hours)	758	0	758
Cost Burden (Dollars)	0	0	0

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Abstract: As delegated by the U.S. Office of Personnel Management (OPM), the NPS is authorized to request information to determine the suitability of applicants for Federal employment and non-Federal personnel (i.e., contractor, partners, etc.) who require access to NPS property and/or receive DOIAccess personal identity verification (PIV) badges. Suitability determinations are authorized under Executive Orders 10450, Applicants for federal employment will complete form 10-152. This includes non-federal personnel, contractors and individuals not otherwise directly employed by the Federal Government - those who perform work for or on behalf of the Federal Government and will require access to NPS property and/or receive a DOIAccess PIV badge.

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Authorizing Statute(s): EO: EO 10450 Name/Subject of EO: Security requirements for Government employment
   EO: EO 10577 Name/Subject of EO: Amending the Civil Service Rules and authorizing a new appointment system for the competitive
   US Code: 5 USC 3301 Name of Law: Civil service; generally
   US Code: 5 USC 3302 Name of Law: Competitive service; rules
   US Code: 5 USC 9101 Name of Law: Criminal history record information for national security purposes
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 53174	10/04/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 5472	01/30/2020
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Background Clearance Initiation Request	10-152	Background Clearance Initiation Request

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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	6,500	6,500	0	0	0	0
Annual Time Burden (Hours)	758	758	0	0	0	0
Annual Cost Burden (Dollars)	0	0	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:

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Annual Cost to Federal Government: $1,021,280

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? No

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Common Form ICR:  No

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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: 01/30/2020

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