Information Collection

DCSA Form 335

IC 224416 under ICR 202603-0704-001 · OMB 0704-0561.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DCSA Form 335 Freedom of Information / Privacy Act Request for Adjudication and Vetting Records DCSA Form 335	Form and Instruction
DCSA Form 335 Freedom of Information / Privacy Act Request for Adjudic DCSA 335_0704-0561.pdf	Form and Instruction

IC Title:

DCSA Form 335

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 32 CFR 310 32 CFR 311

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
Form and Instruction	DCSA Form 335				Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title: DWHS E04: Privacy Act Case Files

FR Citation: 80 FR 19293

Number of Respondents: 1,005

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1,005	885	120
Annual IC Time Burden (Hours)	84	74	10
Annual IC Cost Burden (Dollars)	2,735	2,503	232

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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