Information Collection

Reporting of Security Events

IC 244758 under ICR 202311-3084-002 · OMB 3084-0171.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3084-0171 can be found here:

Documents and Forms

Document Name Document Type
SafeguardsBreachReport_FillableForm.pdf Other-Form that will be made availab
SafeguardsBreachReportForm_Final.pdf Other-Form that will be made availab

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Reporting of Security Events	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 16 CFR 314

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Form that will be made available on FTC website to facilitate reporting			SafeguardsBreachReportForm_Final.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Financial Sector Oversight

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 115	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	115	115	0
Annual IC Time Burden (Hours)	575	575	0
Annual IC Cost Burden (Dollars)	0	37,950	-37,950

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.