CISA OCS Visitor Request Form

Forms and Documents

Document Name	Status
Form 11000-39 CISA OCS Visitor Request Form Form	New
Form 11000-39 NPPD Visitor Request Form Form and Instruction	Removed
1670-0036_CISA OCS Visitor Request Form_SSA_20210721_FINAL.docx Supporting Statement A	2021-07-21
PUBL 30-Day FRN--86 No. 118 FR 32956 on 20210623.pdf Supplementary Document	2021-07-13
PL 107-296 Sec II - The Homeland Security Act, 2002.pdf Supplementary Document	2021-05-20
DHS ALL PIA-039.pdf Supplementary Document	2021-05-20
PUBL 60-Day FRN--86 No. 30 FR 9949 on 20210217.pdf Supplementary Document	2021-05-20
DHS ALL 024.docx Supplementary Document	2017-12-21
DHS ALL 023.docx Supplementary Document	2017-12-21

IC Document Collections

IC ID	Document Title	Status
247545	CISA OCS Visitor Request Form Form	New
229537	NPPD Visitor Request Form Form and Instruction	Removed

ICR Details

OMB Control No: 1670-0036	ICR Reference No: 202105-1670-004
Status: Received in OIRA	Previous ICR Reference No: 201712-1670-003
Agency/Subagency: DHS/CISA	Agency Tracking No:
Title: CISA OCS Visitor Request Form
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/21/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	20,000	0
Time Burden (Hours)	3,333	0
Cost Burden (Dollars)	0	0

---

Abstract: Public Law 107-296 The Homeland Security Act of 2002, Title II, recognizes the Department of Homeland Security role in integrate relevant critical infrastructure and cybersecurity information, analyses, and vulnerability assessments (whether such information, analyses, or assessments are provided or produced by the Department or others) in order to identify priorities for protective and support measures by the Department, other agencies of the Federal Government, State and local government agencies and authorities, the private sector, and other entities while maintaining positive control of sensitive information regarding the national infrastructure. In support of this mission the National Protection and Programs Directorate Office of Compliance and Security must maintain a robust visitor screening capability.

---

Authorizing Statute(s): PL: Pub.L. 107 - 296 II Name of Law: The Homeland Security Act of 2002
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 9949	02/17/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 32956	06/23/2021
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
CISA OCS Visitor Request Form	11000-39	Office of Compliance and Security, NPPD Visitor Request Form
NPPD Visitor Request Form	11000-39	NPPD Visitor Request Form

---

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	20,000	0	0	0	0	20,000
Annual Time Burden (Hours)	3,333	0	0	0	0	3,333
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is a collection is a Reinstatement without change of a previously approved collection and is being brought into compliance with the Paperwork Reduction Act.

---

Annual Cost to Federal Government: $250,473

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/21/2021

---