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Account Request Form
Protected Repository for the Defense of Infrastructure Against Cyber Threats (PREDICT)
OMB: 1640-0012
IC ID: 183216
OMB.report
DHS/S&T
OMB 1640-0012
ICR 201203-1640-003
IC 183216
( )
Documents and Forms
Document Name
Document Type
Form 10029 (12/07)
Account Request Form
Form and Instruction
10029 (12/07) PREDICT Account Request Form
AccountRequestForm_10029_052212.jpg
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Account Request Form
Agency IC Tracking Number:
10029
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
10029 (12/07)
PREDICT Account Request Form
AccountRequestForm_10029_052212.jpg
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Homeland Security
Subfunction:
Key Asset and Critical Infrastructure Protection
Privacy Act System of Records
Title:
SORN DHS/ALL-002
FR Citation:
75 FR 71659
Number of Respondents:
45
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
45
0
0
0
0
45
Annual IC Time Burden (Hours)
11
0
0
0
0
11
Annual IC Cost Burden (Dollars)
0
0
0
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.