Information Collection

Financial Information Security Request Form

IC 178798 under ICR 201401-0596-002 · OMB 0596-0204.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0596-0204 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FS-6500-214 Financial Information Security Request Form	Form
FS-6500-214 Financial Information Security Request Form 0596-0204 Financial Info Security Form FS-6500-214 screenshots v01-22-2014.docx Closed system, only available via FS Intranet	Form

IC Title:

Financial Information Security Request Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

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	FS-6500-214	Financial Information Security Request Form	0596-0204 Financial Info Security Form FS-6500-214 screenshots v01-22-2014.docx	Closed system, only available via FS Intranet	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Fiscal Operations

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 415

Number of Respondents for Small Entity: 415

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	2,000	1,750	250
Annual IC Time Burden (Hours)	600	525	75
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.