Information Collection

User Registration Form

IC 191045 under ICR 200910-1640-001 · OMB 1640-0016.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1640-0016 can be found here:

Documents and Forms

Document Name Document Type
Form DHS Form 10059 (9/ User Registration Form Form
DHS Form 10059 (9/ FrCop Data Collection Instruments_070710 FrCop Data Collection Instruments_070710.pdf communities.firstresponder.gov/web/guest Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	User Registration Form	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DHS Form 10059 (9/09)	FrCop Data Collection Instruments_070710	FrCop Data Collection Instruments_070710.pdf	https://communities.firstresponder.gov/web/guest	Yes	Yes	Fillable Printable

Line of Business: Homeland Security

Subfunction: Catastrophic Defense

Privacy Act System of Records
Title: DHS/ALL-002;DHS/ALL-004	FR Citation: 73 FR 71659

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	2,500	2,500
Annual IC Cost Burden (Dollars)	125,000	125,000

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.