Information Collection

CISA OCS Visitor Request Form

IC 247545 under ICR 202105-1670-004 · OMB 1670-0036.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1670-0036 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 11000-39 CISA OCS Visitor Request Form	Form
11000-39 Office of Compliance and Security, NPPD Visitor Request 1670-0036_CISA OCS Visitor Request Form_3_30-day FRN_INSTRUMENT_v1.pdf	Form
PUBL 60-Day FRN--86 No. 30 FR 9949 on 20210217.pdf 60-Day FRN	IC Document
1670-0036_CISA OCS Visitor Request Form_2_30-day FRN_SS-A_v1.docx 1670-0036_Supporting Statement A	IC Document
PTA, 1670-0036_CISA OCS Visitor Request Form_PRIV PTA_20210108_FINAL.pdf PTA, 1670-0036_CISA OCS Visitor Request Form_PRIV PTA_20210108_FINAL	IC Document
PubL 107-296 Sec II - The Homeland Security Act, 2002.pdf PubL 107-296 Sec II - The Homeland Security Act, 2002	IC Document

IC Title:

CISA OCS Visitor 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	11000-39	Office of Compliance and Security, NPPD Visitor Request Form	1670-0036_CISA OCS Visitor Request Form_3_30-day FRN_INSTRUMENT_v1.pdf		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: 20,000

Number of Respondents for Small Entity: 0

Affected Public: Federal Government

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	20,000	20,000
Annual IC Time Burden (Hours)	3,333	3,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
60-Day FRN	PUBL 60-Day FRN--86 No. 30 FR 9949 on 20210217.pdf	05/20/2021
1670-0036_Supporting Statement A	1670-0036_CISA OCS Visitor Request Form_2_30-day FRN_SS-A_v1.docx	05/20/2021
PTA, 1670-0036_CISA OCS Visitor Request Form_PRIV PTA_20210108_FINAL	PTA, 1670-0036_CISA OCS Visitor Request Form_PRIV PTA_20210108_FINAL.pdf	05/20/2021
PubL 107-296 Sec II - The Homeland Security Act, 2002	PubL 107-296 Sec II - The Homeland Security Act, 2002.pdf	05/20/2021

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.