Counterfeit Electronics Survey

National Security and Critical Technology Assessments of the US Industrial Base

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0694-0119 can be found here:

Documents and Forms

Document Name Document Type
Counterfeit Electronics Survey Form and Instruction
Counterfeit Electronics Survey Counterfeit_Survey.doc Form and Instruction
NAVAIR_Letter.rtf.pdf NAVAIR Letter IC Document
Supporting_Statement.rtf Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	Counterfeit Electronics Survey	Agency IC Tracking Number:	New

IC Status: New

Obligation to Respond: Mandatory

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	NA	Counterfeit Electronics Survey	Counterfeit_Survey.doc		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 98 %

	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	400	0	0	0	0	0
Annual IC Time Burden (Hours)	4,400	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
NAVAIR Letter	NAVAIR_Letter.rtf.pdf	03/18/2008
Supporting Statement	Supporting_Statement.rtf	03/18/2008

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