Information Collection

Supplemental Investigative Data

IC 20434 under ICR 201101-1620-001 · OMB 1620-0001.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form SSF 86A Supplemental Investigative Data	Form and Instruction
SSF 86A Supplemental Investigative Data SSF86A.pdf www.secretservice.gov/forms/ssf86a.pdf	Form and Instruction
83c-fill.pdf Statement of Change to Form SSF 86A	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 31 CFR Section 2.1 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	SSF 86A	Supplemental Investigative Data	SSF86A.pdf	www.secretservice.gov/forms/ssf86a.pdf	Yes	No	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: 10,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	30,000	30,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Statement of Change to Form SSF 86A	83c-fill.pdf	09/07/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.