SAFETY Act Block Certification

Support Anti-terrorism by Fostering Effective Technologies Act of 2002

OMB: 1640-0001

IC ID: 190459

Information Collection (IC) Details

View Information Collection (IC)

SAFETY Act Block Certification
 
No Unchanged
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction DHS Form 10004 SAFETY Act Block Certification 10004_SAFETY_Act_Block_Certification _2_.pdf www.safetyact.gov Yes Yes Fillable Fileable

Homeland Security Key Asset and Critical Infrastructure Protection

 

10 0
   
Private Sector Businesses or other for-profits
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 10 0 0 0 0 10
Annual IC Time Burden (Hours) 500 0 0 0 0 500
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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