Information Collection

Personnel Security System Access Request Form (PSSAR)

IC 217732 under ICR 202111-0704-001 · OMB 0704-0542.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2962 Personnel Security System Access Request Form (PSSAR)	Form and Instruction
2962 Personnel Security System Access Request dd2962v2 draft 20210809.pdf	Form and Instruction
2962 Personnel Security System Access Request dd2962v2 draft 20210809.pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	2962	Personnel Security System Access Request	dd2962v2 draft 20210809.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 22,225

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	22,225	0	22,225
Annual IC Time Burden (Hours)	3,704	0	3,704
Annual IC Cost Burden (Dollars)	134,646	14,261	120,385

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.