Information Collection

Protected Critical Infrastructure Information (PCII) Officer Self-Assessment Questionnaire

IC 207482 under ICR 201306-1670-002 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
8531 - PCII Officer Self-Assessment Questionnaire_v5_07-06-2012 (v5 lg clean).docx	Other-Survey

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 6 CFR 6 CFR 29.4(d) PCII Program

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
Other-Survey			8531 - PCII Officer Self-Assessment Questionnaire_v5_07-06-2012 (v5 lg clean).docx		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records

Title: DHS All-004 - General Informatoin Technology Access Account Records System (GITAARS)

FR Citation: 74 FR 187

Number of Respondents: 80

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	80	80
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	3,811	3,811

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.