DS Request for Security Forms Usage

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3206-0276 PVA Part A	Form and Instruction	Modified	Repair queued
Form 3206-NEW PVQ Certification and Releases	Form and Instruction	Modified	Repair queued
Form 3206-NEW PVQ Part D	Form and Instruction	Modified	Repair queued
Form 3206-NEW PVQ Part C	Form and Instruction	Modified	Repair queued
Form 3206-NEW PVQ Part B	Form and Instruction	Modified	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
265643	Personnel Vetting Questionnaire	Form and Instruction	Modified	PVA Part A
265643	Personnel Vetting Questionnaire	Instruction	Modified
265643	Personnel Vetting Questionnaire	Form and Instruction	Modified	PVQ Certification and Releases
265643	Personnel Vetting Questionnaire	Form and Instruction	Modified	PVQ Part D
265643	Personnel Vetting Questionnaire	Form and Instruction	Modified	PVQ Part C
265643	Personnel Vetting Questionnaire	Form and Instruction	Modified	PVQ Part B

ICR Details

OMB Control No: 3206-0279	ICR Reference No: 202505-1405-002CF
Status: Active	Previous ICR Reference No: 202402-1405-002CF
Agency/Subagency: STATE/AFA	Agency Tracking No:
Title: DS Request for Security Forms Usage
Type of Information Collection: RCF Recertification	Common Form ICR:
Type of Review Request:
OIRA Conclusion Action: Approved	Conclusion Date: 05/01/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/01/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2025	6 Months From Approved	11/30/2026
Responses	18,000	0	18,000
Time Burden (Hours)	43,920	0	43,954
Cost Burden (Dollars)	967,400	0	967,400

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Abstract:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR?

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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 Vetting Questionnaire	3206-NEW, 3206-NEW, 3206-NEW, 3206-NEW, 3206-0276	PVQ Part B ,   PVQ Part C ,   PVQ Part D ,   PVQ Certification and Releases ,   PVA Part A

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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	18,000	18,000	0	0	0	0
Annual Time Burden (Hours)	43,920	43,954	0	0	-34	0
Annual Cost Burden (Dollars)	967,400	967,400	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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:

Does this IC contain surveys, censuses, or employ statistical methods?

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.    

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.    

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? No

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Common Form ICR: 

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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:

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