Information Collection

STC Los Angeles/Long Beach Regional Stakeholder Survey

IC 219616 under ICR 201410-1601-003 · OMB 1601-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1601-0014 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DHS Form 10093 STC Los Angeles/Long Beach Regional Stakeholder Survey	Form
DHS Form 10093 STC Member Questionnaire STC LA LB Questionnaire_FINAL.pdf	Form
STC_ Survey_Clearance_Submission_FINAL.pdf Gen IC Mini Supporting Statement	IC Document
DHS-ALL-PIA-006.pdf Privacy Documentation	IC Document

IC Title:

STC Los Angeles/Long Beach Regional Stakeholder Survey

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

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	DHS Form 10093	STC Member Questionnaire	STC LA LB Questionnaire_FINAL.pdf		Yes	Yes	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: 18

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18	18
Annual IC Time Burden (Hours)	6	6
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Gen IC Mini Supporting Statement	STC_ Survey_Clearance_Submission_FINAL.pdf	01/26/2016
Privacy Documentation	DHS-ALL-PIA-006.pdf	01/19/2016

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