Information Collection

DHS Form 405

IC 247872 under ICR 202211-1601-002 · OMB 1601-0030.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Form DHS Form 405
DHS Form 405
Form and Instruction
Draft IDCMS Portal Screenshots.pdf Other-Mock-up Screenshot
DHS Form 405 DHS Form 405
DHS Form 405.pdf
Form and Instruction
Portal Optionsets and Dropdowns.xlsx
Drop Down Sellections
IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

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 405 DHS Form 405 DHS Form 405.pdf Yes Yes Fillable Printable
Other-Mock-up Screenshot Draft IDCMS Portal Screenshots.pdf Yes Yes Fillable Fileable

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 30,000 0 0 0 0 30,000
Annual IC Time Burden (Hours) 30,000 0 0 0 0 30,000
Annual IC Cost Burden (Dollars) 1,650 0 0 0 0 1,650

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Drop Down Sellections Portal Optionsets and Dropdowns.xlsx 02/01/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.