CISA Speaker Request Form

OMB Control No:	ICR Reference No: 202105-1670-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: DHS/CISA	Agency Tracking No:
Title: CISA Speaker Request Form
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/09/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	1,300	0
Time Burden (Hours)	325	0
Cost Burden (Dollars)	0	0

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Abstract: The Speaker Request Form will be the first point of contact between CISA and the public to initiate CISA speaking engagements. The form will be available on www.cisa.gov and any member of the public can submit a request for a CISA employee to speak at an event. The form will be used by CISA to track and manage external speaking engagements. The information will be used to schedule and determine the most appropriate CISA speaker based on date, time, location, presentation format, and topic. The form collects information about the event, discussion topics, presentation format, media participation, disclosures, special event guest, and event coordinator information. Information from the Speaker Request Form regarding the requested speaking engagement, the host organization, the speaking topic, agenda and additional event details will be collected. The requested information helps CISA determine whether the speaker should attend the engagement and/or how CISA should best prepare for the event. The information is used to determine if the event warrants the time and attention of the invited speaker and what messages and information can be shared on behalf of the Agency with a public or targeted audience. The CISA Speakers Bureau team will use the information to identify a speaker and route the Speakers Request Form to that person for consideration. The information is then sent to DHS Public Affairs for awareness of CISA speaking engagements.

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Authorizing Statute(s): PL: Pub.L. 115 - 278 2201 Name of Law: Cybersecurity and Infrastructure Security Agency Act, 2018    PL: Pub.L. 107 - 296 101 Name of Law: Homeland Security Act, 2002    PL: Pub.L. 104 - 13 3501 Name of Law: Paperwork Reduction Act, 1995    PL: Pub.L. 114 - 185 552 Name of Law: FOIA Improvement Act, 2016

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 82497	12/18/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 15493	03/23/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title Form No. Form Name CISA Speaker Request Form n//a CISA Speaker Request Form

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ICR Summary of Burden

	Total Request	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	1,300	0	0	1,300	0	0
Annual Time Burden (Hours)	325	0	0	325	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a NEW collection.

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Annual Cost to Federal Government:

Does this IC contain surveys, censuses, or employ statistical methods? No

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.     Yes

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.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Mia Bruce 202 357-8441 [email protected]

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Common Form ICR:  No

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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: 06/09/2021

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