Information Collection

DHS Form 405

IC 247872 under ICR 202106-1601-003 · OMB 1601-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1601-0030 can be found here:

Documents and Forms

Document Name Document Type
Form DHS Form 405 DHS Form 405 Form and Instruction
DHS Form 405 DHS Form 405 DHS Form 405.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	DHS Form 405	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 405	DHS Form 405	DHS Form 405.pdf		Yes	Yes	Fillable Fileable Signable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records
Title: Department of Homeland Security/ALL-025 Law Enforcement Authority in Support of the Protection of Property Owned, Occupied, or Secured by the Department of Homeland Security System of Records	FR Citation: 82 FR 27274

Number of Respondents: 30,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30,000	30,000
Annual IC Time Burden (Hours)	30,000	30,000
Annual IC Cost Burden (Dollars)	1,650	1,650

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.