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⚠️ Notice: This information collection may be referencing outdated material.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

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

Information Collection (IC) Details

View Information Collection (IC)

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:

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 %

	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

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.