Information Collection

Indian Health Service Information Security Ticketing and Incident Reporting

IC 231681 under ICR 201803-0917-001 · OMB 0917-0041.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0917-0041 can be found here:

Documents and Forms

Document Name Document Type
ISTS CSIRT Form .pdf Other-web system
ISTS Privacy Form .pdf Other-web form
0917-F07-02b Incident response form F07-02b_IRF_Final.pdf Form and Instruction
OMB ICR Supporting Statement A for Submission_IT Security.docx Indian Health Service Information Security Ticketing and Incident Reporting Part A IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Indian Health Service Information Security Ticketing and Incident Reporting	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-web system			ISTS CSIRT Form .pdf	Yes	Yes	Fillable Fileable
Other-web form			ISTS Privacy Form .pdf	Yes	Yes	Fillable Fileable
Form and Instruction	0917-F07-02b	Incident response form	F07-02b_IRF_Final.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,700	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,700	1,700
Annual IC Time Burden (Hours)	425	425
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Indian Health Service Information Security Ticketing and Incident Reporting Part A	OMB ICR Supporting Statement A for Submission_IT Security.docx	06/07/2018

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