Information Collection

Existing Chemicals Program - CDX Electronic Signature

IC 187656 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form ESA and Authorizat Existing Chemicals Program - CDX Electronic Signature Form
ESA and Authorizat Electronic Signature Agreement and Authorized Official V primary eTSCA CDX ESA & Verif.doc Form
ESA and Authorizat Electronic Signature Agreement (Submission of Supplement supplementary eTSCA CDX ESA & Verif.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Existing 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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ESA and Authorization Form 1	Electronic Signature Agreement and Authorized Official Verification	primary eTSCA CDX ESA & Verif.doc		Yes	No	Fillable Printable
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

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3	3
Annual IC Time Burden (Hours)	5	5
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.