Information Collection

Contractor Fitness/Security Screening Request Form DHS Form 11000-25

IC 263396 under ICR 202311-1601-001 · OMB 1601-0039.

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IC Title:

Contractor Fitness/Security Screening Request Form DHS Form 11000-25

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 5 CFR 731 5 CFR 732

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

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title: DHS/ALL-023 Department of Homeland Personnel Security Management.

FR Citation: 85 FR 64511

Number of Respondents: 45,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	45,000	45,000
Annual IC Time Burden (Hours)	11,250	11,250
Annual IC Cost Burden (Dollars)	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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