Update Provider Data Form

Protected Repository for the Defense of Infrastructure Against Cyber Threats (PREDICT)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1640-0012 can be found here:

Documents and Forms

Document Name Document Type
Form 10034 (12/07) Update Provider Data Form Form and Instruction
10034 (12/07) Update Provider Data PREDICT_UpdateProvider.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Update Provider Data Form	Agency IC Tracking Number:	10034

Is this a Common Form? No		IC Status: Removed

Obligation to Respond: Voluntary

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	10034 (12/07)	Update Provider Data	PREDICT_UpdateProvider.pdf		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: 10	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-10	10
Annual IC Time Burden (Hours)	-3	3
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.