Declaration Submission Form for Critical Technology Pilot Program

Regulations Pertaining to Mergers, Acquisitions and Takeovers by Foreign Persons

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1505-0121 can be found here:

Documents and Forms

Document Name Document Type
Declaration Submission Form Guidelines 11.5.18.docx Instruction
CFIUS Declaration Declaration Submission Form for Critical Technology Pilo Declaration Submission Form for Critical Technology Pilot Program.pdf Form

Information Collection (IC) Details

IC Title:	Declaration Submission Form for Critical Technology Pilot Program	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 31 CFR 800

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Declaration Submission Form Guidelines 11.5.18.docx		Yes	Yes	Fillable Fileable
Form	CFIUS Declaration Form	Declaration Submission Form for Critical Technology Pilot Program	Declaration Submission Form for Critical Technology Pilot Program.pdf		Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 250	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	5,000	5,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.