Information Collection

Request for Determination of CVI

IC 191764 under ICR 201001-1670-005 · OMB 1670-0015.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1670-0015 can be found here:

Documents and Forms

Document Name Document Type
Form DHS Form 9028 Request for Determination of CVI Form and Instruction
DHS Form 9028 REQUEST FOR DETERMINATION OF CHEMICAL-TERRORISM VULNERAB Request for Determination of CVI 12.17.09.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Determination of CVI	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

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	DHS Form 9028	REQUEST FOR DETERMINATION OF CHEMICAL-TERRORISM VULNERABILITY INFORMATION (CVI)	Request for Determination of CVI 12.17.09.pdf		Yes	Yes	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: 250	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	63	63
Annual IC Cost Burden (Dollars)	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.