Industry Outreach Form

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DHS-1640-0036 DHS Industry Outreach Information Form	Form and Instruction	New	Available
Supporting Statement A_DHS_Industry Outreach_Form.docx	Supporting Statement A	Uploaded 2018-10-31	Available
USCODE-2010-title6-chap1-subchapIII-sec193.pdf	Supplementary Document	Uploaded 2018-10-31	Available
83FedRegNotice 15865.pdf	Supplementary Document	Uploaded 2018-10-31	Available
82FedRegNotice 32567.pdf	Supplementary Document	Uploaded 2018-10-31	Available
SORN_2013-00602.pdf	Supplementary Document	Uploaded 2018-10-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
231511	DHS S&T Industry Outreach Information Form	Form and Instruction	New	DHS Industry Outreach Information Form

ICR Details

OMB Control No: 1640-0019	ICR Reference No: 201611-1640-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DHS/S&T	Agency Tracking No:
Title: Industry Outreach Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/18/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/16/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2022	36 Months From Approved
Responses	312	0	0
Time Burden (Hours)	234	0	0
Cost Burden (Dollars)	28,105	0	0

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Abstract: The Department of Homeland Security (DHS), Science & Technology (S&T) Directorate invites the general public to comment on the DHS S&T Industry Outreach Information data collection forms for the Public-Private Partnerships (P3) who resides within the Research and Development Partnerships group (RDP). S&T/RPD/P3 is responsible for coordinating the collection of Industry Information,. This authority charges the P3 Office with the collection of relevant information of companies, including their contact and product information. Any and all information provided by companies is completely voluntary; companies are not required to submit any requested information.

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Authorizing Statute(s): US Code: 6 USC 193 Name of Law: Technology clearinghouse to encourage and support innovative solutions to enhance homeland security
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 14869	07/14/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 15865	04/12/2018
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
DHS S&T Industry Outreach Information Form	DHS-1640-0036	DHS Industry Outreach Information Form

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	312	0	0	312	0	0
Annual Time Burden (Hours)	234	0	0	234	0	0
Annual Cost Burden (Dollars)	28,105	0	0	28,105	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new collection.

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Annual Cost to Federal Government: $4,187

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 11/16/2018

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