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pdfROBA COLLECTION SCREEN SHOTS
CONTRACTORNENDOR ENTRYFORM
Page 1 of 11
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0MB NO. 0702-0135
0MB approval expires
DEC 31, 2025
AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0702-0135, is estimated to average 30 minutes per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. Send comments regarding the burden
estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at whs.mc
[email protected]. Respondents should be aware that notwithstanding any other
provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does
not display a currently valid 0MB control number.
PRIVACY ACT STATEMENT
AUTHORITY: 10 U.S.C. §7103, "Secretary of the Army"; 10 U.S.C. §9013, "Secretary of the Air Force;" United States
Presidential Executive Order (E.O.) 13526, "Classified National Security;" E.O. 10450, "Security Requirements for
Government Employment;" Department of Defense Instruction (DoDI) 5200.01, "DoD Information Security Program and
Protection of Sensitive Compartmental Information;" DoDI 5200.02, "DoD Personnel Security Program (PSP);" Army
Regulation (AR) 380-67, "Personnel Security Program;" Air Force Instruction (AFI) 31-501, "Personnel Security Program
Management;" AFI 31-401, "Information Security Program Management;" AR 215-8/DAFI 34-110(i), "Army and Air Force
Exchange Service Operations;" and E.O. 9397, (SSN), as amended.
PRINCIPAL PURPOSES: To assist in the processing of personnel security clearance actions; to record security clearances
issued or denied, and to verify for access to classified information or assignment to sensitive positions.
ROUTINE USES: Records may be disclosed outside of DoD pursuant to Title 5 U.S.C. §552a(b)(3) regarding DoD "Blanket
Routine Uses" published at http://dpcld.defense.gov/Privacy/SORNslndex/BlanketRoutineUses.aspx. Information may
be released to Federal agencies based on formal accreditation as specified in official directives; regulations; to Federal,
State, Local, and Foreign Law Enforcement, Intelligence, or Security agencies in connection with a lawful investigation
under their jurisdiction.
DISCLOSURE: Voluntary, however, failure to provide information may result in denial of a Common Access Card; non
enrollment in the Defense Enrollment Eligibility Reporting System (DEERS); refusal to grant access to DoD installations,
buildings, facilities, computer systems and networks; and denial of DoD benefits if otherwise authorized.
A copy of the Privacy Impact Assessment (PIA) for the collection of information may be located at
https://www.aafescom/about-exchange/public-affairs/FOIA/assessments.htm.
SYSTEM OF RECORDS NOTICE (SORN): 1703.03, "Personnel Security Clearance Case Files;"
https://dpcld.defense.gov/Privacy/SORNslndex/DOD-Component-Notices/Army-Article-List/
File Type | application/pdf |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |