Information Collection

Form CSO-005, Preliminary Background Check Form

IC 231179 under ICR 202106-1105-001 · OMB 1105-0105.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1105-0105 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CSO-005 Form CSO-005, Preliminary Background Check Form	Form and Instruction
CSO-005 Preliminary Background Check Form cso005-rev.pdf	Form and Instruction
CSO-005 Preliminary Background Check Form cso005-rev.pdf	Form and Instruction

IC Title:

Form CSO-005, Preliminary Background Check Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

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	CSO-005	Preliminary Background Check Form	cso005-rev.pdf		Yes	No	Fillable Printable

Line of Business: Workforce Management

Subfunction: Training and Employment

Privacy Act System of Records

Title: OPM/Govt-1, General Personnel Records

FR Citation: 76 FR 32997

Number of Respondents: 750

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	750	750
Annual IC Time Burden (Hours)	1,125	1,125
Annual IC Cost Burden (Dollars)	14,651	14,651

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.