View Information Collection (IC)

View Information Collection (IC)

IC Title:	Information Request	Agency IC Tracking Number:	10012

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DHS Form 10012 (04/07)	Information Request	DHS Form 10012 - Information Request.pdf	https://www.techsolutions.dhs.gov	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Homeland Security

Subfunction: Catastrophic Defense

Privacy Act System of Records
Title: DHS/ALL-004	FR Citation: 74 FR 49882

Number of Respondents: 22	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	22	0	-228	0	0	250
Annual IC Time Burden (Hours)	2	0	-19	0	0	21
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

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.