Information Collection

Notice of Modification

IC 190452 under ICR 202409-1640-002 · OMB 1640-0001.

Documents and Forms

Document Name Document Type
Form DHS Form 10002 Notice of Modification Form and Instruction
DHS Form 10002 Notice of Modification 10002_Notice_of_Modification.pdf Form and Instruction
DHS Form 10002 Notice of Modification 10002_Notice_of_Modification.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Notice of Modification	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 10002	Notice of Modification	10002_Notice_of_Modification.pdf		Yes	No	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Catastrophic Defense

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	20	20
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	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.