Information Collection

Personnel Security System Access Request Form (PSSAR)

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

Documents and Forms

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

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Personnel Security System Access Request Form (PSSAR)	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:

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 %

	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

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.