Form DHS Form 9035 DHS Form 9035 Notification of New Top-Screen

Top-Screen Update Instrument

For inclusion within ICR 1670-0014

Cybersecurity and Infrastructure Security Agency

Paperwork Reduction Act Statement

In accordance with the Paperwork Reduction Act, no one is required to respond to a collection of information unless it displays a valid Office of Management and Budget (OMB) Control Number. The valid OMB Control Number for this information collection is 1670-0014. The time required to complete this information collection is estimated to average 0.08 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

Privacy Notice

Authority: The Protecting and Securing Chemical Facilities from Terrorist Attacks Act of 2014, Pub. L. No. 113-254 which is also codified at 6 U.S.C. § 621 et seq., as amended by Pub. L. No. 116-136, Sec. 16007 (2020) and the Chemical Facility Anti-Terrorism Standards (CFATS), 6 C.F.R. Part 27 authorize the collection of this information.

Purpose: The primary purpose of this collection is to obtain information regarding a covered chemical facility, including the submitter's contact information, in order to ensure compliance with CFATS.

Routine Uses: This information will be used by and disclosed to Department of Homeland Security (DHS) personnel, contractors, stakeholders outside the Federal government, or other agents, including but not limited to other Federal, state, and local officials; to assist in fulfilling the request, contacting the submitter, any administrative follow up actions required to ensure compliance with 6 part 27, provided the recipient demonstrates a need to know in order to carry out official duties.

Disclosure: Providing this information is mandatory. If a covered chemical facility does not provide this information, then CISA has authority to pursue administrative enforcement action against the facility for failure to submit a revised Top-Screen, including the issuance of an administrative order, penalty order assessing a civil penalty, and/or an order to cease operations. See 6 U.S.C. § 624; 6 C.F.R. § 27.300.

Basic Reporting Fields

CISA may collect the following basic information:

• Identification of CVI Authorized User status

• Submitter’s CVI Authorized User Status Number

• Name of the Submitter: (Last, First, MI)

• Phone Number of the Submitter

• Facility Name

• CSAT Facility ID #

• Facility's Address (Street, City, State, Zip)

• Date Submitted

Top Screen Update

In this section, CISA collects through this instrument, the reason a facility submits an updated Top-Screen. In many instances, the collection may be concurrent with a facility’s submission of a Top-Screen pursuant to 6 CFR § 27.210(d). The information may also be collected after reviewing a Top-Screen.

The reason for the updated Top Screen:

• Closure or sale of the facility;

• Addition of a new Chemical of Interest (COI);

• Elimination or changes to the amount of existing COI;

• Other

In addition, the facility will provide a narrative description of:

• Explanation for Submission;

• Desired outcome of the request

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