Information Collection

DHS S&T Industry Outreach Information Form

IC 231511 under ICR 201611-1640-001 · OMB 1640-0019.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DHS-1640-0036 DHS S&T Industry Outreach Information Form	Form and Instruction
DHS-1640-0036 DHS Industry Outreach Information Form DHS Industry Outreach Information Form.pdf	Form and Instruction
83FedRegNotice 15865.pdf 83 Federal Registry Notice 15865	IC Document
82FedRegNotice 32567.pdf 82 Federal Registry Notice 32567	IC Document
Document_Metadata-DHS-2017-0036-DRAFT-0002-05_10_2018-12_44_PM.pdf 30 Day Comment 1	IC Document
Document_Metadata-DHS-2017-0036-DRAFT-0003-05_10_2018-12_45_PM.pdf 30 Day Comment 2	IC Document
Document_Metadata-DHS-2017-0036-DRAFT-0004-05_10_2018-12_48_PM.pdf 30 Day Comment 3	IC Document
USTR 2017-0014.pdf 60 Day Comment	IC Document
PTA, S&T - Industry Outreach.pdf PTA DHS Industry Outreach	IC Document
SORN_2013-00602.pdf System of Record Notice	IC Document
Supporting Statement A_DHS_Industry Outreach_Form.docx Supporting Statement A	IC Document
USCODE-2010-title6-chap1-subchapIII-sec193.pdf US Code 6 section 193	IC Document

IC Title:

Agency IC Tracking Number:

1640-NEW

Is this a Common Form? No

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 and Instruction	DHS-1640-0036	DHS Industry Outreach Information Form	DHS Industry Outreach Information Form.pdf		Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records

Title: â¢DHS/S&T-001 - Research, Development, Test, and Evaluation Records

FR Citation: 78 FR 3019

Number of Respondents: 312

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	312	312
Annual IC Time Burden (Hours)	234	234
Annual IC Cost Burden (Dollars)	28,105	28,105

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
83 Federal Registry Notice 15865	83FedRegNotice 15865.pdf	05/18/2018
82 Federal Registry Notice 32567	82FedRegNotice 32567.pdf	05/18/2018
30 Day Comment 1	Document_Metadata-DHS-2017-0036-DRAFT-0002-05_10_2018-12_44_PM.pdf	05/18/2018
30 Day Comment 2	Document_Metadata-DHS-2017-0036-DRAFT-0003-05_10_2018-12_45_PM.pdf	05/18/2018
30 Day Comment 3	Document_Metadata-DHS-2017-0036-DRAFT-0004-05_10_2018-12_48_PM.pdf	05/18/2018
60 Day Comment	USTR 2017-0014.pdf	05/18/2018
PTA DHS Industry Outreach	PTA, S&T - Industry Outreach.pdf	05/18/2018
System of Record Notice	SORN_2013-00602.pdf	05/18/2018
Supporting Statement A	Supporting Statement A_DHS_Industry Outreach_Form.docx	05/18/2018
US Code 6 section 193	USCODE-2010-title6-chap1-subchapIII-sec193.pdf	05/18/2018

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