Information Collection

Security

IC 23402 under ICR 202110-1910-006 · OMB 1910-1800.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-1800 can be found here:

2023-08-10 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOE F 5631.34 Security	Form and Instruction
Form DOE F 5631.34 Data Report on Spouse Cohabitant Security	Form and Instruction
Form DOE F 5631.5 The Conduct of Personnel Security Interviews Security	Form and Instruction
Form DOE F 5631.18 Security Acknowledgement Security	Form and Instruction
Form DOE F 5631.20 Request for Visit or Access Approval Security	Form
Form DOE F 5639.3 Report of Security Incident/Infraction Security	Form
Form DOE F 473.2 Badge Request Electronic Security	Form and Instruction
Form DOE F 472.3 Foreign Citizenship Acknowledgement Security	Form
Form DOE F 471.1 Security Incident Notification Report Security	Form and Instruction
Form DOE F 5631.29 Security Termination Statement Security	Form
Form Standard Form 328 Certificate Pertaining to Foreign Interests Security	Form
Form DOE F 473.3 Clearance Access Request Security	Form and Instruction
FACTS Screen Shots.pdf	Other-FACTS Screenshot
FACTS Screen Shots.pdf	Other-FACTS Screenshot
DOE F 5631.34 Data Report on Spouse Cohabitant DOE F 5631 34 Data Report on Spouse Cohabitant 10-2021.pdf	Form and Instruction
DOE F 5631.34 Data Report on Spouse Cohabitant DOE F 5631 34 Data Report on Spouse Cohabitant 10-2021.pdf	Form and Instruction
DOE F 5631.5 The Conduct of Personnel Security Interviews DOE F 5631.5 The Conduct of Personnel Security Interviews 10-2021.pdf	Form and Instruction
DOE F 5631.5 The Conduct of Personnel Security Interviews DOE F 5631.5 The Conduct of Personnel Security Interviews 10-2021.pdf	Form and Instruction
DOE F 5631.18 Security Acknowledgement DOE F 5631.18 Security Acknowledgement 10-2021.pdf	Form and Instruction
DOE F 5631.18 Security Acknowledgement DOE F 5631.18 Security Acknowledgement 10-2021.pdf	Form and Instruction
DOE F 5631.20 Request for Visit or Access Approval DOE F 5631.20 Request for Visit or Access Approval 10-2021.pdf	Form
DOE F 5631.20 Request for Visit or Access Approval DOE F 5631.20 Request for Visit or Access Approval 10-2021.pdf	Form
DOE F 5639.3 Report of Security Incident/Infraction DOE F 5639.3 Report of Security Incident - Infraction 10-2021.pdf	Form
DOE F 5639.3 Report of Security Incident/Infraction DOE F 5639.3 Report of Security Incident - Infraction 10-2021.pdf	Form
DOE F 473.2 Badge Request Electronic DOE F 473.2 Badge Request Electronic 10-2021.pdf	Form and Instruction
DOE F 473.2 Badge Request Electronic DOE F 473.2 Badge Request Electronic 10-2021.pdf	Form and Instruction
DOE F 472.3 Foreign Citizenship Acknowledgement DOE F 472.3 Foreign Citizenship Acknowledgement 10-2021.pdf	Form
DOE F 472.3 Foreign Citizenship Acknowledgement DOE F 472.3 Foreign Citizenship Acknowledgement 10-2021.pdf	Form
DOE F 471.1 Security Incident Notification Report DOE F 471.1 Security Incident Notification Report 10-2021.pdf	Form and Instruction
DOE F 471.1 Security Incident Notification Report DOE F 471.1 Security Incident Notification Report 10-2021.pdf	Form and Instruction
DOE F 5631.29 Security Termination Statement DOE F 5631.29 Security Termination Statement 10-2021.pdf	Form
DOE F 5631.29 Security Termination Statement DOE F 5631.29 Security Termination Statement 10-2021.pdf	Form
Standard Form 328 Certificate Pertaining to Foreign Interests OMB 1910-1800 SF-328.pdf	Form
Standard Form 328 Certificate Pertaining to Foreign Interests OMB 1910-1800 SF-328.pdf	Form
DOE F 473.3 Clearance Access Request DOE F 473.3 Clearance Access Request.pdf	Form and Instruction
DOE F 473.3 Clearance Access Request DOE F 473.3 Clearance Access Request.pdf	Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Security

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.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DOE F 5631.34	Yes	Yes	Fillable Fileable Signable
Form and Instruction	DOE F 5631.5	Yes	Yes	Fillable Fileable Signable
Form and Instruction	DOE F 5631.18	Yes	Yes	Fillable Fileable Signable
Form	DOE F 5631.20	Yes	Yes	Fillable Fileable Signable
Form	DOE F 5639.3	Yes	Yes	Fillable Fileable Signable
Other-FACTS Screenshot		Yes	Yes	Fillable Fileable
Form and Instruction	DOE F 473.2	Yes	Yes	Fillable Fileable
Form	DOE F 472.3	Yes	Yes	Fillable Fileable Signable
Form and Instruction	DOE F 471.1	Yes	Yes	Fillable Fileable
Form	DOE F 5631.29	Yes	Yes	Fillable Fileable Signable
Form	Standard Form 328	Yes	Yes	Fillable Fileable Signable
Form and Instruction	DOE F 473.3	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 75,661

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 83 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	84,621	-2,272	86,893
Annual IC Time Burden (Hours)	13,251	1,955	11,296
Annual IC Cost Burden (Dollars)	1,192,590	-145,800	1,338,390

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.

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