Information Collection

Chemical-terrorism Vulnerability Information (CVI) Authorization

IC 191763 under ICR 201704-1670-002 · OMB 1670-0015.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1670-0015 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DHS Form 9012 Chemical-terrorism Vulnerability Information (CVI) Authorization	Form and Instruction
DHS Form 9012 Chemical-terrorism Vulnerability information Training & CVI AUTHORIZATION Instrument_8 August 2017.docx	Form and Instruction

IC Title:

Chemical-terrorism Vulnerability Information (CVI) Authorization

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	DHS Form 9012	Chemical-terrorism Vulnerability information Training & Authorized User Application	CVI AUTHORIZATION Instrument_8 August 2017.docx		Yes	Yes	Fillable Fileable Signable

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: 20,000

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	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	20,000	-10,000	30,000
Annual IC Time Burden (Hours)	10,000	-20,000	30,000
Annual IC Cost Burden (Dollars)	0	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.