National Defense University Security Office Forms

Forms and Documents

Document Name	Status
NDU Security In-Process Form Form	New
NDU Nomination for NACI Form Form	New
0704-NDUS_SSA_10.27.2021.docx Supporting Statement A	2021-10-28
0704-NDUS_DraftSORN_9.13.2021.docx Supplementary Document	2021-09-16
NDU SSN Justification Memo_Signed_6.28.2019.pdf Supplementary Document	2021-09-16
0704-NDUS_PIA_8.24.2020.pdf Supplementary Document	2021-08-26

IC Document Collections

IC ID	Document Title	Status
247867	NDU Security In-Process Form Form	New
247860	NDU Nomination for NACI Form Form	New

ICR Details

OMB Control No:	ICR Reference No: 202106-0704-004
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: DOD/DODDEP	Agency Tracking No: 0704-NDUS
Title: National Defense University Security Office Forms
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/28/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	225	0
Time Burden (Hours)	44	0
Cost Burden (Dollars)	743	0

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Abstract: Respondents to this collection are National Defense University (NDU) employees who must provide information to the NDU Security Office to facilitate essential personnel, facility, and information security functions. This includes information necessary to initiate a background investigation for CAC card issuance (NDU Nomination for NACI Form) and information for in-processing and PIV credentialing (NDU Security In-Process Form).

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Authorizing Statute(s): US Code: 10 USC 2165 Name of Law: National Defense University
   US Code: 10 USC 2163 Name of Law: Degree Granting Authority for National Defense University
   EO: EO 9397 Name/Subject of EO: Federal Agency Use of Social Security Numbers
  

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:
	85 FR 81457	12/16/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 51657	09/16/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
NDU Nomination for NACI Form	N/A	National Defense University Nomination for National Agency Check w/Inquiries Form
NDU Security In-Process Form	N/A	National Defense University Security In-Processing Request Form

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ICR Summary 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	225	0	0	225	0	0
Annual Time Burden (Hours)	44	0	0	44	0	0
Annual Cost Burden (Dollars)	743	0	0	743	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: This is an existing collection currently in use without an OMB Control Number.

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Annual Cost to Federal Government: $4,149

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: 10/28/2021

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