Information Collection

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

IC 5289 under ICR 201607-0704-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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 TAB_C_DD_Form_441_(new).PDF Form
DD Form 441-1 Appendage to Department of Defense Security Agreement TAB_D_DD_Form_441-1_(new).PDF Form
SF 328 Certificate Pertaining to Foreign Interests TAB_E_SF_328_(new)Rev3.PDF Form

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: Voluntary

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	TAB_C_DD_Form_441_(new).PDF	Yes	Yes	Fillable Printable
Form	DD Form 441-1	Appendage to Department of Defense Security Agreement	TAB_D_DD_Form_441-1_(new).PDF	Yes	Yes	Fillable Printable
Form	SF 328	Certificate Pertaining to Foreign Interests	TAB_E_SF_328_(new)Rev3.PDF	Yes	Yes	Fillable Printable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,851	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 99 %

	Approved	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	6,851	1,569	5,282
Annual IC Time Burden (Hours)	4,171	-3,663	7,834
Annual IC Cost Burden (Dollars)	182,702	-904,821	1,087,523

Documents for IC

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.