Information Collection Request

SAFECOM Membership Questionnaire

ICR 202507-1670-005 · OMB 1670-0046 · Active

Forms and Documents
DocumentTypeStatusAvailability
SAFECOM Membership Questionnaire Form and Instruction Modified Repair queued
SAFECOM Membership Questionnaire Form and Instruction Modified Repair queued
2025-16490.pdf Supplementary Document Uploaded 2025-08-28 Repair queued
2025-16490.pdf Supplementary Document Uploaded 2025-08-28 Missing upstream
CFR-2013-title3-vol1-eo13618.pdf Supplementary Document Uploaded 2025-08-18 Available
CFR-2013-title3-vol1-eo13618.pdf Supplementary Document Uploaded 2025-08-18 Repair queued
SORN - DHS-All-069.pdf Supplementary Document Uploaded 2025-08-18 Available
SORN - DHS-All-069.pdf Supplementary Document Uploaded 2025-08-18 Repair queued
2025-11003.pdf Supplementary Document Uploaded 2025-08-18 Repair queued
2025-11003.pdf Supplementary Document Uploaded 2025-08-18 Repair queued
PTA, CISA - SAFECOM Membership Questionnaire, 20240124, PRIV Final.pdf Supplementary Document Uploaded 2025-08-18 Available
PTA, CISA - SAFECOM Membership Questionnaire, 20240124, PRIV Final.pdf Supplementary Document Uploaded 2025-08-18 Available
PLAW-107-296 - Homeland Security Act, 2002.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
PLAW-107-296 - Homeland Security Act, 2002.pdf Supplementary Document Uploaded 2021-05-07 Missing upstream
PIA_DHS-ALL-061 - HSIN 3.0 Shared Spaces On The Sensitive But Unclassified Network.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
PIA_DHS-ALL-061 - HSIN 3.0 Shared Spaces On The Sensitive But Unclassified Network.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
PIA_DHS-ALL-006 - DHS General Contact Lists.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
PIA_DHS-ALL-006 - DHS General Contact Lists.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
DHS-ALL–002 - Department of Homeland Security (DHS) Mailing and Other Lists System.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
DHS-ALL–002 - Department of Homeland Security (DHS) Mailing and Other Lists System.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
6 USC 652 - Cybersecurity and Infrastructure Security Agency.pdf Supplementary Document Uploaded 2021-05-07 Available
6 USC 652 - Cybersecurity and Infrastructure Security Agency.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
6 USC 571 - Office of Emergency Communications.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
6 USC 571 - Office of Emergency Communications.pdf Supplementary Document Uploaded 2021-05-07 Repair queued
1670-0046_SAFECOM Membership Questionnaire_SSA_FINAL_2-5-25.docx Supporting Statement A Uploaded 2025-08-28 Repair queued
1670-0046_SAFECOM Membership Questionnaire_SSA_FINAL_2-5-25.docx Supporting Statement A Uploaded 2025-08-28 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
247241 SAFECOM Membership Questionnaire Form and Instruction ModifiedN/A
247241 SAFECOM Membership Questionnaire Form and Instruction Modified
ICR Details
1670-0046 202507-1670-005
Active 202105-1670-001
DHS/CISA PRA-ECD-00002411
SAFECOM Membership Questionnaire
Reinstatement without change of a previously approved collection   No
Regular
Approved without change 01/08/2026
Retrieve Notice of Action (NOA) 08/28/2025
  Inventory as of this Action Requested Previously Approved
01/31/2029 36 Months From Approved
91 0 0
23 0 0
0 0 0

The SAFECOM Membership Questionnaire is an internal SAFECOM document disseminated only to active SAFECOM Members. SAFECOM uses the Questionnaire to identify membership gaps, obtain updated information on SAFECOM’s membership body (e.g., public safety communications experience, accolades, acquired skills/certifications, etc.), update SAFECOM marketing materials, and to assist SAFECOM when responding General Accounting Office (GAO) inquiries. The Questionnaire will encompass eight interdependent sections of questions. The SAFECOM Internal Membership section requests each Member to provide their name, state of residence, and the number of hours per month he/she contributes SAFECOM led initiatives (e.g., conference calls and deliverable development). SAFECOM consists of public safety association representatives and at-large members. The Association Representative Information section pertains to public safety associations represented in SAFECOM. Association Representatives serving in SAFECOM are asked to provide the name of their Association, approximate Association size, Association contact, and addition Association point-of-contact (POC) information. At-large members are instructed to skip to the next section. Public Safety Service section will focus on questions related to each Member’s public safety and first responder career. Members are asked to designate their current public safety status (i.e., active, retired, other), to identify their public safety discipline(s), to provide level of government for current employment (e.g., state, local, tribal, territorial, federal), to provide years of service, to list current agency and agency’s contact information, to provide a brief description on their current role and responsibilities, to select the population range that best describes the population of your current organization’s jurisdiction serviced, to indicate the number of public safety personnel employed at your current organization, to indicate the number of responses your current organization responds to each year, and if current position entails collaborating with Tribal Nations. The Volunteer Experience section asks Members to provide details on their volunteer experience. The Public Safety Experience section asks Members to identify the public safety events he/she responded to throughout their career, and to identify the communications technology he/she has used. The Education section focuses on the education (e.g., which is an optional question), proficiencies, and professional certifications. External Conference Attendance section focuses on Member’s experience at public safety conferences as well as their interest in representing SAFECOM in the future at a conference. The final section focuses on Members public safety usage.

US Code: 6 USC 652 Name of Law: Cybersecurity and Infrastructure Agency
   PL: Pub.L. 107 - 296 101 Name of Law: Homeland Security Act, 2002
   EO: EO 13618 Name/Subject of EO: Assignment of National Security and Emergency Preparedness Communications Functions
   US Code: 6 USC 571 Name of Law: Office of Emergency Communications
  
None

Not associated with rulemaking

  90 FR 25355 06/16/2025
90 FR 42030 08/28/2025
No

1
IC Title Form No. Form Name
SAFECOM Membership Questionnaire N/A N/A

  Total Approved 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 91 0 0 0 41 50
Annual Time Burden (Hours) 23 0 0 0 10 13
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The burden increase was due to an increase in the total number of respondents to the information collection.

$268
No
    Yes
    Yes
No
No
No
No
Benjamin Thomsen 202 254-7179 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/28/2025