Information Collection

Technical Assistance (TA) Evaluation Form - 9042

IC 197202 under ICR 202309-1670-002 · OMB 1670-0023.

Documents and Forms

Document Name Document Type
Form DHS Form 9042 Technical Assistance (TA) Evaluation Form - 9042 Form and Instruction
DHS Form 9042 CISA Technical Assistance (TA) Evaluation Form CISA_Technical_Assistance_Evaluation_Form_7_2020.pdf Form and Instruction
DHS Form 9042 CISA Technical Assistance (TA) Evaluation Form CISA_Technical_Assistance_Evaluation_Form_7_2020.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Technical Assistance (TA) Evaluation Form - 9042	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

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 9042	CISA Technical Assistance (TA) Evaluation Form	CISA_Technical_Assistance_Evaluation_Form_7_2020.pdf		Yes	Yes	Fillable Fileable

Line of Business: Homeland Security

Subfunction: Key Asset and Critical Infrastructure Protection

Privacy Act System of Records
Title: Department of Homeland Security Mailing and Other Lists System of Records	FR Citation: 73 FR 71659

Number of Respondents: 128	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	Approved	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	128	128
Annual IC Time Burden (Hours)	11	11
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.