Information Collection

Optional Questionnaire

IC 190886 under ICR 200904-2070-001 · OMB 2070-0176.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0176 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 6300-05-Q Optional Questionnaire	Form
6300-05-Q Optional Questionnaire Level of Effort for Recipients of 2249.01_Amendment-F2_Optional-Qs-2009-09-18.pdf	Form

IC Title:

Optional Questionnaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

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	6300-05-Q	Optional Questionnaire Level of Effort for Recipients of Tier 1 Screening Orders	2249.01_Amendment-F2_Optional-Qs-2009-09-18.pdf		Yes	Yes	Fillable Printable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 384

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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	384	384
Annual IC Time Burden (Hours)	243	243
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.