Information Collection

Authorization Letter for Data Host

IC 183225 under ICR 201006-1640-002 · OMB 1640-0012.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 10038 (12/07) Authorization Letter for Data Host	Form and Instruction
10038 (12/07) Authorization Letter for Data Host 10038_PREDICT_AuthorizationLtr_DH_v1.2.docx	Form and Instruction

IC Title:

Authorization Letter for Data Host

Agency IC Tracking Number:

10038

Is this a Common Form? No

IC Status: Modified

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 and Instruction	10038 (12/07)	Authorization Letter for Data Host	10038_PREDICT_AuthorizationLtr_DH_v1.2.docx		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	1	-9	10
Annual IC Time Burden (Hours)	1	-9	10
Annual IC Cost Burden (Dollars)	0	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.