Information Collection

CISA Speaker Request Form

IC 247259 under ICR 202105-1670-002 · OMB 1670-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1670-0047 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form n//a CISA Speaker Request Form	Form and Instruction
n//a CISA Speaker Request Form 1670-NEW_CISA Speaker Request Form_INSTRUMENT_PRE APPROVAL_FINAL (3-MAY-2021).pdf	Form and Instruction

IC Title:

CISA Speaker Request Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	n//a	CISA Speaker Request Form	1670-NEW_CISA Speaker Request Form_INSTRUMENT_PRE APPROVAL_FINAL (3-MAY-2021).pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,300

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
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,300	1,300
Annual IC Time Burden (Hours)	325	325
Annual IC Cost Burden (Dollars)	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.