Defense Counterintelligence and Security Agency (DCSA) Freedom of Information / Privacy Act Request for Adjudication Records

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DCSA Form 335 Freedom of Information / Privacy Act Request for Adjudication and Vetting Records	Form and Instruction	Modified	Available
0704-0561_SSA_3.31.26.docx	Supporting Statement A	Uploaded 2026-03-31	Available
SSNJ_Memo_0704-0561.pdf	Supplementary Document	Uploaded 2026-03-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
224416	DCSA Form 335	Form and Instruction	Modified	Freedom of Information / Privacy Act Request for Adjudication and Vetting Records
224416	DCSA Form 335	Form and Instruction	Modified

ICR Details

OMB Control No: 0704-0561	ICR Reference No: 202603-0704-001
Status: Received in OIRA	Previous ICR Reference No: 202301-0704-003
Agency/Subagency: DOD/DODDEP	Agency Tracking No:
Title: Defense Counterintelligence and Security Agency (DCSA) Freedom of Information / Privacy Act Request for Adjudication Records
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/31/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2026
Responses	1,005	120
Time Burden (Hours)	84	10
Cost Burden (Dollars)	2,735	232

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Abstract: The Freedom of Information and Privacy (FOIP) Office for Adjudications and Vetting, a component of the Defense Counterintelligence and Security Agency, is responsible for administering the provisions of the Freedom of Information Act and the Privacy Act. The collection of personal information in a standardized format is necessary to ensure that we have the necessary information to positively identify individuals who request records contained within DSCA national security systems of records. Additionally, it will help to reduce the risk of releasing highly sensitive information inadvertently to someone misidentified.

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Authorizing Statute(s): US Code: 5 USC 552a
   US Code: 10 USC 113
   EO: EO 9397
  

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:
	91 FR 4070	01/30/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 15979	03/31/2026
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
DCSA Form 335	DCSA Form 335	Freedom of Information / Privacy Act Request for Adjudication and Vetting Records

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	1,005	120	0	885	0	0
Annual Time Burden (Hours)	84	10	0	74	0	0
Annual Cost Burden (Dollars)	2,735	232	0	2,503	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: The burden has increased due to a significant rise in the number of respondents since our previous submission is due to the discontinuation of other informal request templates and the socialization of the form to more of the population.

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Annual Cost to Federal Government: $100,522

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: 03/31/2026

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