Information Collection

Information Collection for Self-Certification to the EU_U.S. and Swis-U.S. Privacy Shield Framework

IC 222570 under ICR 202011-0625-001 · OMB 0625-0276.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PS questionnaire_Failure to Recertify_03-23-2017.docx www.privacyshield.gov/welcome	Other-Questionnaire
PS questionnaire_Compliance Review_03-23-2017.docx privacyshield.gov/welcome	Other-Questionnaire
PS questionnaire_Post-Withdrawal Data Retention_03-23-2017.docx privacyshield.gov/welcome	Other-Questionnaire
PS questionnaire_Withdrawal_03-23-2017.docx privacyshield.gov/welcome	Other-Questionnaire
PS self-certification form_web version_03-23-2017.docx www.privacyshiled.gov/welcome	Other-Word Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionnaire	PS questionnaire_Failure to Recertify_03-23-2017.docx	https://www.privacyshield.gov/welcome	Yes	Yes	Fillable Fileable
Other-Questionnaire	PS questionnaire_Compliance Review_03-23-2017.docx	https://privacyshield.gov/welcome	Yes	Yes	Fillable Fileable
Other-Questionnaire	PS questionnaire_Post-Withdrawal Data Retention_03-23-2017.docx	https://privacyshield.gov/welcome	Yes	Yes	Fillable Fileable
Other-Questionnaire	PS questionnaire_Withdrawal_03-23-2017.docx	https://privacyshield.gov/welcome	Yes	Yes	Fillable Fileable
Other-Word Document	PS self-certification form_web version_03-23-2017.docx	https://www.privacyshiled.gov/welcome	Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,100

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	Previously Approved
Annual Number of Responses for this IC	5,100	5,100
Annual IC Time Burden (Hours)	3,400	3,400
Annual IC Cost Burden (Dollars)	6,923,250	6,923,250

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.