Information Collection

Supplemental Investigative Data

IC 20434 under ICR 201101-1620-001 · OMB 1620-0001.

Documents and Forms

Document Name Document Type
Form SSF 86A Supplemental Investigative Data Form and Instruction
SSF 86A Supplemental Investigative Data SSF86A.pdf www.secretservice.gov/forms/ssf86a.pdf Form and Instruction
83c-fill.pdf Statement of Change to Form SSF 86A IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Supplemental Investigative Data	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 31 CFR Section 2.1 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	SSF 86A	Supplemental Investigative Data	SSF86A.pdf	www.secretservice.gov/forms/ssf86a.pdf	Yes	No	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 85 %

	Requested	Previously Approved
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	30,000	30,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Statement of Change to Form SSF 86A	83c-fill.pdf	09/07/2006

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.