Information Collection

Proposal Coversheet

IC 182283 under ICR 200710-1640-001 · OMB 1640-0009.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DHS Form 10017 Proposal Coversheet	Form
DHS Form 10017 Proposal Coversheet DHS FORM 10017 - Proposal Coversheet Screen Shot.pdf demo.sainc.com/hsarpasbir/registered/CoverCreate.asp	Form

IC Title:

Proposal Coversheet

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DHS Form 10017	Proposal Coversheet	DHS FORM 10017 - Proposal Coversheet Screen Shot.pdf	http://demo.sainc.com/hsarpasbir/registered/CoverCreate.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: 460

Number of Respondents for Small Entity: 460

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	460	460
Annual IC Time Burden (Hours)	230	230
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.