Forms and Documents

Document Name	Status
Form Form SCI IC19 - Material systems change notice required by Rule 1003(a)(2) Form and Instruction	Modified
Form Form SCI IC14 - SCI event notice required by Rule 1002(b)(5) Form and Instruction	Modified
Form Form SCI IC13 - SCI event notice required by Rule 1002(b)(4) Form and Instruction	Modified
Form Form SCI IC12 - SCI event notice required by Rule 1002(b)(3) Form and Instruction	Modified
Form Form SCI IC11 - SCI event notice required by Rule 1002(b)(2) Form and Instruction	Modified
Form Form SCI IC21 - SCI review required by Rule 1003(b)(3) Form and Instruction	Modified
Form Form SCI IC20 - SCI review required by Rule 1003(b)(1) and (b)(2) Form and Instruction	Modified
Form Form SCI IC18 - Material systems change notice required by Rule 1003(a)(1) Form and Instruction	Modified
Form Form SCI IC10 - SCI event notice required by Rule 1002(b)(1) Form and Instruction	Modified
3235-0703 2021-25173.pdf Supplementary Document	2022-01-20
3235-0703.pdf Supplementary Document	2022-01-20
Reg. SCI and Form SCI Supporting Statement 2021.pdf Supporting Statement A	2021-11-10
Form SCI.pdf Supplementary Document	2021-04-14

IC Document Collections

IC ID	Document Title	Status
232088	IC29 - Recordkeeping required by Rules 1005 and 1007 - ongoing burden	Modified
232087	IC27 - Identification of critical SCI systems, major SCI events, de minimis SCI events, and material systems changes - ongoing burden	Modified
232086	IC25 - Corrective action required by Rule 1002(a) - ongoing burden	Modified
232085	IC23 - Access to EFFS - EAUF - existing entities	Modified
232079	IC19 - Material systems change notice required by Rule 1003(a)(2) Form and Instruction	Modified
232078	IC17 - Dissemination of information required by Rule 1002(c)(2)	Modified
232077	IC16 - Dissemination of information required by Rule 1002(c)(1)(ii)	Modified
232076	IC14 - SCI event notice required by Rule 1002(b)(5) Form and Instruction	Modified
232075	IC13 - SCI event notice required by Rule 1002(b)(4) Form and Instruction	Modified
232074	IC12 - SCI event notice required by Rule 1002(b)(3) Form and Instruction	Modified
232073	IC11 - SCI event notice required by Rule 1002(b)(2) Form and Instruction	Modified
232072	IC9 - Mandate participation in certain testing for non-plan processors required by Rule 1004 - ongoing burden	Modified
232071	IC7 - Policies and procedures required by Rule 1001(c) - ongoing burden	Modified
232068	IC5 - Policies and procedures required by Rule 1001(b) -ongoing burden - SCI non-SROs	Modified
232067	IC4 - Policies and procedures required by Rule 1001(b) - ongoing burden - SCI SROs	Modified
232066	IC2 - Policies and procedures required by Rule 1001(a) - ongoing burden	Modified
216647	IC 31 - Access to EFFS - digital ID	Modified
216646	IC22 - Access to EFFS - EAUF - new entities	Modified
216640	IC6 - Policies and procedures required by Rule 1001(c) - initial burden	Modified
207227	IC28 - Recordkeeping required by Rules 1005 and 1007 - initial burden	Modified
207226	IC26 - Identification of critical SCI systems, major SCI events, de minimis SCI events, and material systems changes - initial burden	Modified
207225	IC24 - Corrective action required by Rule 1002(a) - initial burden	Modified
207224	IC21 - SCI review required by Rule 1003(b)(3) Form and Instruction	Modified
207223	IC20 - SCI review required by Rule 1003(b)(1) and (b)(2) Form and Instruction	Modified
207214	IC18 - Material systems change notice required by Rule 1003(a)(1) Form and Instruction	Modified
207212	IC15 - Dissemination of information required by Rule 1002(c)(1)(i)	Modified
207211	IC10 - SCI event notice required by Rule 1002(b)(1) Form and Instruction	Modified
207210	IC30 - Mandate participation in certain testing for plan processors required by Rule 1004	Modified
207209	IC8 - Mandate participation in certain testing for non-plan processors required by Rule 1004 - initial burden	Modified
207208	IC3 - Policies and procedures required by Rule 1001(b) - initial burden	Modified
207206	IC1 - Policies and procedures required by Rule 1001(a) - initial burden	Modified

ICR Details

OMB Control No:	ICR Reference No:
Status:	Previous ICR Reference No:
Agency/Subagency:	Agency Tracking No:
Title:
Type of Information Collection:	Common Form ICR:
Type of Review Request:	Date Received in OIRA:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract:

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR?

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Number of Information Collection (IC) in this ICR: 0

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ICR Summary of Burden

	Total	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	0	0	0	0	0	0
Annual Time Burden (Hours)	0	0	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion:

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion:

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods?

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.    

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.    

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?

Is this ICR related to the Pandemic Response?

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Common Form ICR: 

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date:

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