Information Collection

Declaration of Reporting Status

IC 226471 under ICR 201704-1670-001 · OMB 1670-0014.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1670-0014 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Declaration of Reporting Status	Form and Instruction
Declaration of Reporting Screenshots.pdf	Other-screenshots
Declaration of Reporting Status Declaration of Reporting Status_1 Aug 2017.docx	Form and Instruction

IC Title:

Declaration of Reporting Status

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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	N/a	Declaration of Reporting Status	Declaration of Reporting Status_1 Aug 2017.docx		Yes	Yes	Fillable Fileable
Other-screenshots			Declaration of Reporting Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records

Title: Mailing and Other Lists System

FR Citation: 73 FR 71659

Number of Respondents: 480

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	480	480
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.