Form DHS Form 10017 DHS Form 10017 Proposal Coversheet

DHS SBIR/STTR Proposal Coversheet Form
Cover Sheet
1. Department Name: Department of Homeland Security
2. Component/Agency Name: Science and Technology Directorate, Office of Innovation
3. OMB Control Number: 1640-New
4. Expiration Date: TBD (three years from approval date)
5. Agency Form Number: DHS FORM 10017 (5/07)
6. Name of Form: DHS SBIR/STTR Proposal Coversheet
7. Purpose of Form: Allow a member of the public to prepare a coversheet for a proposal he or
she submits to the DHS SBIR/STTR Program Office for consideration.
8. How to submit: Submit online at www.sbir.dhs.gov or mail to Department of Homeland
Security, Science and Technology/Office of Innovation, SBIR Program, Room 8-050, 245
Murray Drive, Washington, DC, 20528.