Personnel Security System Access Request Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2962 Personnel Security System Access Request Form (PSSAR)	Form and Instruction	Modified	Available
0704-0542_SSA_12.30.2021.docx	Supporting Statement A	Uploaded 2021-12-30	Available
0704-0542_SSN_10.25.2019.pdf	Supplementary Document	Uploaded 2021-12-29	Available
0704-0542_SORN_10.17.2018.pdf	Supplementary Document	Uploaded 2021-12-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217732	Personnel Security System Access Request Form (PSSAR)	Form and Instruction	Modified

ICR Details

OMB Control No: 0705-0009	ICR Reference No: 202203-0705-001
Status: Active	Previous ICR Reference No: 201809-0704-002
Agency/Subagency: DOD/OUSDI	Agency Tracking No:
Title: Personnel Security System Access Request Form
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/23/2022
	Date Received in OIRA: 03/23/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2025	36 Months From Approved
Responses	22,225	0	22,225
Time Burden (Hours)	3,704	0	3,704
Cost Burden (Dollars)	134,646	0	120,385

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Abstract: Personnel systems across the Department of Defense (DoD), including National Background Investigation Services, the Defense Information System for Security, the Defense Central Index of Investigations, the Secure Web Fingerprint Transmission require personal data collection to facilitate the initiation, investigation and adjudication of information relevant to DoD security clearances and employment suitability determinations for active duty military, civilian employees and contractors seeking such credentials. These Personnel Security Systems are the authoritative source for clearance information resulting in accesses determinations to sensitive/classified information and facilities. The DD 2962 v2, Personnel Security System Access Request Form is used to collect the necessary information to vet and establish accounts for industry Facility Security Officers (FSOs) wishing to become users and gain access to these systems.

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Authorizing Statute(s): EO: EO 10450 Name/Subject of EO: Security Requirements for Government Employment
   US Code: 50 USC 435 Name of Law: Purposes
   EO: EO 10865 Name/Subject of EO: Safeguarding Classified Information Within Industry
   EO: EO 12333 Name/Subject of EO: United States Intelligence Activities
   EO: EO 12829 Name/Subject of EO: National Industrial Security Program
   US Code: 50 USC 401 Name of Law: Congressional Declaration of purpose
   EO: EO 12968 Name/Subject of EO: Access to Classified Information
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 47480	08/25/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 74407	12/30/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Personnel Security System Access Request Form (PSSAR)	2962	Personnel Security System Access Request

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	22,225	22,225	0	0	0	0
Annual Time Burden (Hours)	3,704	3,704	0	0	0	0
Annual Cost Burden (Dollars)	134,646	120,385	0	14,261	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $125,136

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 12/30/2021

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