Information Collection

Refusal to Consent

IC 44898 under ICR 200608-1910-013 · OMB 1910-5122.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5122 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOE F 470.6 Refusal of Consent Refusal to Consent	Form
DOE F 470.6 Refusal of Consent 470-6[1].pdf	Form

IC Title:

Refusal to Consent

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 10 CFR 712.15(c)

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DOE F 470.6				Yes	No	Printable Only

Line of Business: Defense and National Security

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11,500

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	11,500	11,500
Annual IC Time Burden (Hours)	1,150	1,150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.

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