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

Documents and Forms

Document Name Document Type
8531 - PCII Officer Self-Assessment Questionnaire_v5_07-06-2012 (v5 lg clean).docx Other-Survey

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Protected Critical Infrastructure Information (PCII) Officer Self-Assessment Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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

Information Collection 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 %

	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

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.