Information Collection

New Chemicals Program - CDX Electronic Signature

IC 187652 under ICR 200812-2070-003 · OMB 2070-0173.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0173 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form ESA and Authorizat New Chemicals Program - CDX Electronic Signature	Form
ESA and Authorizat Electronic Signature Agreement (Submission of Supplement supplementary eTSCA CDX ESA & Verif.doc	Form
ESA and Authorizat Electronic Signature Agreement and Authorized Official V primary eTSCA CDX ESA & Verif.doc	Form

IC Title:

New Chemicals Program - CDX Electronic Signature

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

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	ESA and Authorization Form 2	Electronic Signature Agreement (Submission of Supplemental Information Only) and Authorized Official Verification	supplementary eTSCA CDX ESA & Verif.doc		Yes	No	Fillable Printable
Form	ESA and Authorization Form 1	Electronic Signature Agreement and Authorized Official Verification	primary eTSCA CDX ESA & Verif.doc		Yes	No	Fillable Printable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 295

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	98	98
Annual IC Time Burden (Hours)	172	172
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.