Form 10034 (12/07) 10034 (12/07) Update Provider Data

Protected Repository for the Defense of Infrastructure Against Cyber Threats (PREDICT)

PREDICT_UpdateProvider

Update Provider Data Form

OMB: 1640-0012

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1640-0012 can be found here:

2012-08-08 - Revision of a currently approved collection
2010-08-31 - Revision of a currently approved collection

Document [pdf]

Download: pdf | pdf

OMB No. 1640-New
Expires: TBD
DHS PREDICT Update Provider Data Form
Cover Sheet
1. Department Name: Department of Homeland Security
2. Component/Agency Name: Science and Technology Directorate
3. OMB Control Number: 1640-New
4. Expiration Date: TBD (Three years from approval date)
5. Agency Form Number:
6. Name of Form: Update Provider Data Form
7. Purpose of Form: Allows Data Providers to update the information on
provided datasets in the PREDICT system
8. How to submit: Via Website, www.Predict.org

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File Type	application/pdf
File Modified	2008-04-16
File Created	2007-11-26