Application for SAFETY Act Certification

Support Anti-terrorism by Fostering Effective Technologies Act of 2002

Documents and Forms

Document Name Document Type
Form DHS Form 10007 Application for SAFETY Act Certification Form and Instruction
DHS Form 10007 Application for Safety Act Certification 10007_Application_for_SAFETY_Act_Certification.pdf www.safetyact.gov Form and Instruction

Information Collection (IC) Details

IC Title:	Application for SAFETY Act Certification	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DHS Form 10007	Application for Safety Act Certification	10007_Application_for_SAFETY_Act_Certification.pdf	www.safetyact.gov	Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	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 Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	50	-50	50	50
Annual IC Time Burden (Hours)	2,000	-2,000	2,000	2,000
Annual IC Cost Burden (Dollars)	0	-68,160	68,160	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.