Information Collection

Request for Emergency or Term Access to National Security

IC 215769 under ICR 201503-1110-002 · OMB 1110-0066.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1110-0066 can be found here:

Documents and Forms

Document Name Document Type
Form FD-1116 Request for Emergency or Term Access to National Security Form
FD-1116 Request for Emergency or Term Access to National Securit FD-1116_form.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Emergency or Term Access to National Security	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FD-1116	Request for Emergency or Term Access to National Security	FD-1116_form.pdf		No		Fillable Fileable

Line of Business: Law Enforcement

Subfunction: Criminal Investigation and Surveillance

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	23	23
Annual IC Cost Burden (Dollars)	0	0

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.