Information Collection

Email Mailing List Signup

IC 182282 under ICR 200710-1640-001 · OMB 1640-0009.

Documents and Forms

Document Name Document Type
Form DHS Form 10016 Email Mailing List Signup Form
DHS Form 10016 E-mail List sign-up DHS Form 1640-10016- Screen Shot.pdf demo.sainc.com/hsarpasbir/mailinglist/newmailinguser.asp Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Email Mailing List Signup	Agency IC Tracking Number:	DHS Form 10016

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DHS Form 10016	E-mail List sign-up	DHS Form 1640-10016- Screen Shot.pdf	http://demo.sainc.com/hsarpasbir/mailinglist/newmailinguser.asp	Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 300

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	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.