IHS Background Investigations of Individuals in Positions Involving Regular Contact with or Control Over Indian Children

OMB 0917-0028

To collect information needed to determine whether a prospective or current employee that has regular contact with or control over Indian children meets the minimum standards or character and to conduct background investigation.

The latest form for IHS Background Investigations of Individuals in Positions Involving Regular Contact with or Control Over Indian Children expires 2022-02-28 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form 0917-0028 IHS Background Investigation of Individuals in Positions Involving Regular Contact with or Control Over Indian Children Form and Instruction
Final_AddendumtoDeclarationorFederalEmploymentOGCPHD final copy 9.20.18.doc Supplementary Document
0917-0028_Supporting_Statement_A__2022 FINAL 2.24.22.docx Supporting Statement A
Title_42_chap_132_13041._Requirement_for_background_checks[1].doc Supplementary Document
USCODE-2011-title25-chap34-sec3207.pdf Supplementary Document
OMB Form No. 3206-0182 0306[1].pdf Supplementary Document
IHS Background Investigation of Individuals in Positions Involving Regular Contact with or Control Over Indian Children Form and Instruction

All Historical Document Collections

202201-0917-002 Approved without change	Extension without change of a currently approved collection	2022-02-24
201811-0917-002 Approved without change	Extension without change of a currently approved collection	2018-11-28
201509-0917-001 Approved without change	Extension without change of a currently approved collection	2015-09-25
201209-0917-001 Approved without change	Extension without change of a currently approved collection	2012-09-05
200902-0917-001 Approved with change	Revision of a currently approved collection	2009-02-20
200511-0917-001 Approved without change	Revision of a currently approved collection	2005-11-10
200405-0917-002 Approved without change	No material or nonsubstantive change to a currently approved collection	2004-05-06
200209-0917-001 Approved without change	New collection (Request for a new OMB Control Number)	2002-09-11