Form M-10B Form M-10B Supplement to Personnel File Checklist

Updated: 4/11/19							OMB 0970-0564 [valid through MM/DD/2024]
THE PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to allow ORR Monitoring Team staff to ensure that programs are meeting ORR policies and procedures related to the maintenance of personnel files during biennial site visits. Public reporting burden for this collection of information is estimated to average 1.0 hour per response (if the site visit is performed by a contractor monitor), including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a mandatory collection of information (Homeland Security Act, 6 U.S.C. 279). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of information please contact [email protected].
Personnel/Contractor/Volunteer File SUPPLEMENT
Program Name:
Date of Review:
#	Name	Position	Start Date	Date passed/cleared FBI check	Notes	Date passed/cleared CA/N (all states where a resident for last 5 years)	Notes
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