Declaration of Reporting Status

DECLARATION OF REPORTING STATUS 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 1670-0014. The time required to complete this information collection is estimated to average 0.25 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. Privacy Notice

Authority: 6 U.S.C. §§ 621-29 (Protecting and Securing Chemical Facilities from Terrorist Attacks Act of 2014) and the Chemical Facility Anti-Terrorism Standards, 6 C.F.R. Part 27 authorize the collection of this information.

Purpose: The primary purpose of this collection is to obtain information regarding why a facility is not required to register and submit a Top-Screen.

Routine Uses: This information will be used by and disclosed to Department of Homeland Security (DHS) personnel, contractors, or other agents to assist a chemical facility of interest’s request to provide a reason supporting its declaration that it is not required to register in the CSAT system or to submit a Top-Screen to DHS. This information may also be required in order to contact the facility, if necessary.

Disclosure: Providing this information is voluntary. If you choose not to provide this information, then DHS may require on-site verification by a DHS Inspector.

3. BASIC REPORTING FIELDS

The following basic reporting fields are required by the Declaration of Reporting Status instrument:

• Name of the Submitter: (Last, First, MI).

• Facility Name.

• Facility's Address (Street, City, State, Zip)

• Phone Number of the Submitter.

• Date Submitted.

4. DECLARATION OF REPORTING STATUS

In this section, the chemical facility of interest provides a reason that supports its declaration that it is not required to register in the CSAT system or to submit a Top-Screen to DHS. The instrument provides the following list of potential reasons that may selected to support a facility’s declaration that it is not required to register or to submit a Top-Screen:

• The facility does not possess a chemical of interest (COI) that meets or exceeds the screening threshold quantity (STQ) described in Appendix A to CFATS.

• The facility is regulated under the Maritime Transportation Security Act of 2002. See 6 U.S.C. § 621(4)(A). **Note: If only a portion of the facility is exempt, the facility must still file a Top-Screen for the portion of the facility that is not regulated.

• The facility is constitutes a wastewater or drinking water facility regulated under authorities administered by the U.S. Environmental Protection Agency. See 6 U.S.C. §§ 621(4)(B) and (C).

• The facility is owned or operated by the Department of Defense or the Department of Energy See 6 U.S.C. § 621(4)(D).

• The facility is subject to regulation by the Nuclear Regulatory Commission (NRC), or by a State that has entered into an agreement with the NRC to protect against unauthorized access of any material, activity, or structure licensed by the NRC. See 6 U.S.C. § 621(4)(E).

• The facility is an agricultural production facility covered under the extension to the Top Screen requirements detailed in 73 Fed. Reg. 1640 (Jan. 9, 2008).

• The facility only possesses a COI present in a gasoline mixture. See 81 Fed. Reg. 47002.

• Other (The facility will provide a narrative).