Information Collection

Background Clearance Initiation Request

IC 223393 under ICR 201912-1024-003 · OMB 1024-0282.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0282 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10-152 Background Clearance Initiation Request	Form and Instruction
10-152 Background Clearance Initiation Request 10-152 Background Clearance Initiation Request.12.9.2019.docx	Form and Instruction

IC Title:

Background Clearance Initiation Request

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	10-152	Background Clearance Initiation Request	10-152 Background Clearance Initiation Request.12.9.2019.docx		Yes	Yes	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: DOI-45, HSPD-12: Identity Management System and Personnel Security Files

FR Citation: 72 FR 11036

Number of Respondents: 6,500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 95 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	6,500	6,500
Annual IC Time Burden (Hours)	758	758
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.