Information Collection

"Department of Defense Security Agreement", "Appendage to Department of Defense Security Agreement", "Certificate Pertaining to Foreign Interests"

IC 5289 under ICR 200803-0704-002 · OMB 0704-0194.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0704-0194 can be found here:

Documents and Forms

Document Name Document Type
Form DD Form 441 "Department of Defense Security Agreement", "Appendage to Department of Defense Security Agreement", "Certificate Pertaining to Foreign Interests" Form
DD Form 441 Department of Defense Security Agreement dd0441.pdf Form
DD Form 441-1 Appendage to Department of Defense Security Agreement dd0441-1.pdf Form
Standard Form 328 Certificate Pertaining to Foreign Interests sf328.pdf Form
Revisions to DD 441 and 441-1.doc Revisions to DD 441/441-1 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	"Department of Defense Security Agreement", "Appendage to Department of Defense Security Agreement", "Certificate Pertaining to Foreign Interests"	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DD Form 441	Department of Defense Security Agreement	dd0441.pdf	Yes	No	Fillable Printable
Form	DD Form 441-1	Appendage to Department of Defense Security Agreement	dd0441-1.pdf	Yes	No	Fillable Printable
Form	Standard Form 328	Certificate Pertaining to Foreign Interests	sf328.pdf	Yes	No	Fillable Printable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,641	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	5,282	-858	6,140
Annual IC Time Burden (Hours)	7,834	-1,274	9,108
Annual IC Cost Burden (Dollars)	1,087,523	1,087,523	0

Documents for IC

Title	Document	Date Uploaded
Revisions to DD 441/441-1	Revisions to DD 441 and 441-1.doc	03/31/2008

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