Information Collection

Request for Redetermination

IC 191775 under ICR 202107-1670-001 · OMB 1670-0014.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DHS Form 9037 Request for Redetermination	Form and Instruction
Request for Redetermination Screenshots.pdf	Other-screenshots
DHS Form 9037 Request for Determination 1670-0014_CFATS_Request for Redetermination INSTRUMENT (05-FEB-2021).docx	Form and Instruction

IC Title:

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:

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	DHS Form 9037	Request for Determination	1670-0014_CFATS_Request for Redetermination INSTRUMENT (05-FEB-2021).docx		Yes	Yes	Fillable Fileable
Other-screenshots			Request for Redetermination 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: 250

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	250	-375	625
Annual IC Time Burden (Hours)	63	-93	156
Annual IC Cost Burden (Dollars)	0	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.