Installation Records Check ADN

DEPARTMENT OF DEFENSE

INSTALLATION RECORDS CHECK

(IRC)

OMB CONTROL NUMBER: 0704-0586

OMB EXPIRATION DATE: 20200930

AGENCY DISCLOSURE NOTICE

The public reporting burden for this collection of information, OMB Control Number 0704-0586, is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at [email protected]. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PRIVACY ACT STATEMENT

AUTHORITY – 34 United States Code §20351 and/or P.L. 101-647 Section 231; DoD Instruction 1402.05, Criminal History Background Checks on Individuals in Child Care Services Programs. (Revised DoDI 1402.05 title: “Background Checks on Individuals Providing Care and Services to Children in DoD Programs”.

PRINCIPAL PURPOSES(S):

The installation records check (IRC) is part of the screening and criminal history background check referenced within the 34 U.S.C 20351 and DoDI 1402.05 “Background Checks on Individuals in DoD Child Care Services Programs”, that include current DoD employees, employment applicants, contractors, Family Child Care (FCC) In-home providers, adults residing in the FCC home, and volunteers. This pre-employment and reverification screening will include checks of the Family Advocacy Central Registry, the military law enforcement records and the Defense Central Index of Investigations (DCII) for individuals providing care and services to children in DoD programs on military installations.

When completed, records are covered by one of the appropriate SORNs:

DoD: Defense Central Index of Investigations (DCII), DMDC 13 DoD

(https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570716/dmdc-13-dod/), DITPR #6697

Army: A0215-3 SAMR, NAF Personnel Records (https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570010/a0215-3-samr/), DITPR #593 and,

A0690-200 DAPE, Department of the Army Civilian Personnel System (https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-view/Article/570099/a0690-200-dape/), DITPR #6080

Navy and Marine Corps: NM01754-3, DON Child and Youth Program (https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/570428/nm01754-3/), DITPR #NM01754-3

Air Force: F034 AF SVA C, Child Development/Youth Programs Records (https://dpcld.defense.gov/Privacy/SORNsIndex/DOD-wide-SORN-Article-View/Article/569755/f034-af-sva-c/), DITPR #11299.

ROUTINE USES: This form will be initiated by DoD staff and will be maintained in the initiating DoD offices and/or appropriate Human Resources/Security offices. Information received as a result of this release may be used to assess interim/on-going or final suitability determination for personnel working with children in DoD sanctioned programs. The DoD “Blanket Routine Uses” found at http://dpcld.defense.gov/Privacy/SORNsIndex/Blanket-Routine-Uses/ may apply to these records.

DISCLOSURE: Voluntary: however, failure to furnish all requested information may result in an unfavorable adjudication decision and may affect suitability of the individual to work with children.