Request for an Extension

Chemical Facility Anti-Terrorism Standards

Documents and Forms

Document Name Document Type
Form DHS Form 9036 Request for an Extension Form and Instruction
Request for Extension Screenshots.pdf Other-screenshots
DHS Form 9036 Request for An Extension 1670-0014_CFATS_Request for Extension INSTRUMENT (05-FEB-2021).docx Form and Instruction

Information Collection (IC) Details

IC Title:	Request for an Extension	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DHS Form 9036	Request for An Extension	1670-0014_CFATS_Request for Extension INSTRUMENT (05-FEB-2021).docx		Yes	Yes	Fillable Fileable
Other-screenshots			Request for Extension Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title: Mailing and Other Lists System	FR Citation: 73 FR 71659

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	500	-230	730
Annual IC Time Burden (Hours)	42	-16	58
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.