Notice for Certificate of Data Destruction

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1640-0012 can be found here:

Documents and Forms

Document Name Document Type
Form 10042 (12/07) Notice for Certificate of Data Destruction Form and Instruction
10042 (12/07) Notice for Certificate of Data Destruction 10042_PREDICT_Data Destruction_v2.0.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Notice for Certificate of Data Destruction	Agency IC Tracking Number:	10042

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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	10042 (12/07)	Notice for Certificate of Data Destruction	10042_PREDICT_Data Destruction_v2.0.docx		Yes	No	Fillable Printable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 15	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	15	5	10
Annual IC Time Burden (Hours)	4	1	3
Annual IC Cost Burden (Dollars)	0	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.