Form TBD Identification of Facilities Assets At Risks Instrument

Identification of Facilities & Assets at Risks Instrument

1. Paperwork Reduction Act Statement

In accordance with the Paperwork Reduction Act, no one is required to respond to a collection of information unless it displays a valid Office of Management and Budget (OMB) Control Number. The valid OMB Control Number for this information collection is 1670-0007. The time required to complete this information collection is estimated to average 0.17 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

2. Identification of Facilities

In this section the instrument will collect, on a voluntary basis, the following information when the facility identifies it ships and/or receives COI:

• Shipping and/or receiving procedures

• Invoices and receipts

• Company names and locations that COI is shipped to and/or received from

This collection is on a voluntary basis and facilities are not required to provide this information to the Department for the purposes of complying with any portion of 6 CFR Part 27.

3. Assets at Risks

In this section the instrument will collect, on a voluntary basis, the following information when the facility identifies a SCADA, DCS, PCS, or ICS:

• Provide details on the system(s) that controls, monitors, and/or manages small to large production systems as well as how the system(s) operates.

• If it is standalone or connected to other systems or networks and document the specific brand and name of the system(s)

This collection is on a voluntary basis and facilities are not required to provide this information to the Department for the purposes of complying with any portion of 6 CFR Part 27.