Information Collection

CISA Out-Processing Information Form

IC 244402 under ICR 202310-0704-001 · OMB 0704-0598.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CISA_End_of_Year_Information_Form_AY_23_Oct 2023.docx	Other-Form
CISA_End_of_Year_Information_Form_AY_23_Oct 2023.docx	Other-Form
CISA_ReminderEmail.pdf Reminder Email	IC Document
CISA_ReminderEmail.pdf Reminder Email	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-Form					Yes	Yes	Fillable Fileable

Line of Business: Defense and National Security

Subfunction: Operational Defense

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 125

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	125	85	40
Annual IC Time Burden (Hours)	21	14	7
Annual IC Cost Burden (Dollars)	1,146	779	367

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Reminder Email		11/04/2020

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

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