Financial Disclosure Report

ICR 201112-3440-001

OMB: 3440-0001

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2009-05-15
IC Document Collections
IC ID
Document
Title
Status
32571 Modified
ICR Details
3440-0001 201112-3440-001
Historical Active 200709-3095-002
ODNI
Financial Disclosure Report
Revision of a currently approved collection   No
Regular
Approved without change 12/16/2011
Retrieve Notice of Action (NOA) 12/16/2011
  Inventory as of this Action Requested Previously Approved
06/30/2012 36 Months From Approved
25,897 0 25,897
51,794 0 51,794
0 0 0

This information collection is used to make personnel security determinations, including whether to grant a security clearance; to allow access to classified information, sensitive areas, and equipment; or to permit assignment to sensitive national security positions. The data may later be used as a part of a review process to evaluate continued eligibility for access to classified information or as evidence in legal proceedings.

EO: EO 12958 Name/Subject of EO: Classified National Security Information
  
None

Not associated with rulemaking

  74 FR 9307 03/03/2009
74 FR 22598 05/13/2009
No

1
IC Title Form No. Form Name
Financial Disclosure Report SF 714 Financial Disclosure Report

  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 25,897 25,897 0 0 0 0
Annual Time Burden (Hours) 51,794 51,794 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
No
Uncollected
Tamee Fechhelm 301-837-3204 tamee.fechhelm@nara.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/15/2009


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