Information Collection

Reporting of Security Events

IC 244758 under ICR 202601-3084-002 · OMB 3084-0171.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
SafeguardsBreachReportForm_Final.pdf	Other-Form that will be made availab
SafeguardsBreachReportForm_Final.pdf	Other-Form that will be made availab

IC Title:

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:

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 that will be made available on FTC website to facilitate reporting					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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	115	0	115
Annual IC Time Burden (Hours)	604	29	575
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.

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