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OMB Control No: 3206-0279	ICR Reference No: 202610-3141-001CF
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: NIGC	Agency Tracking No:
Title: NIGC use of Personnel Vetting Questionnaire
Type of Information Collection: RCF New	Common Form ICR:
Type of Review Request:	Date Submitted to OIRA: 10/09/2026

	Requested	Previously Approved
Expiration Date
Responses	30	0
Time Burden (Hours)	73	0
Cost Burden (Dollars)	1,612	0

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion
Annual Number of Responses	30	30
Annual Time Burden (Hours)	73	73
Annual Cost Burden (Dollars)	1,612	1,612

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: Periodic update to standard security forms. Increase in effort from previous form expected to be minimal.

Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods?

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.

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.

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

Agency Contact: Tim Osumi 202 632-7054 tim_osumi@nigc.gov

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