Water Efficiency Collection - Individuals

EPA's WaterSense Program (Renewal)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2040-0272 can be found here:

Documents and Forms

Document Name Document Type
Form 6100-17 Water Efficiency Collection - Individuals Form and Instruction
Attachment 22 Consumer Awareness Telephone Survey.pdf Other-Draft Telephone Survey
6100-17 Awards Application Irrigation Partner Attachment 20 awards_irrigation.pdf epa.gov/watersense/docs/awards_irrigation508.pdf Form and Instruction
6100-07 Partnership Agreement Certified Professional Attachment 6 irrigation partner PA.pdf www.epa.gov/watersense/docs/partnership_certprofessionals508.pdf Form and Instruction
6100-XX4 Annual Reporting Form Irrigation Partner Attachment 15 Irrigation_PartnerReporting.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Water Efficiency Collection - Individuals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	6100-17	Awards Application Irrigation Partner	Attachment 20 awards_irrigation.pdf	http://epa.gov/watersense/docs/awards_irrigation508.pdf	Yes	Yes	Fillable Printable
Form and Instruction	6100-07	Partnership Agreement Certified Professional	Attachment 6 irrigation partner PA.pdf	http://www.epa.gov/watersense/docs/partnership_certprofessionals508.pdf	Yes	Yes	Fillable Printable
Other-Draft Telephone Survey			Attachment 22 Consumer Awareness Telephone Survey.pdf		No	No	Printable Only
Form and Instruction	6100-XX4	Annual Reporting Form Irrigation Partner	Attachment 15 Irrigation_PartnerReporting.pdf		Yes	Yes	Printable Only

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 668	Number of Respondents for Small Entity: 668

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	668	0	-4,332	5,000
Annual IC Time Burden (Hours)	4,350	0	-35,650	40,000
Annual IC Cost Burden (Dollars)	6,171	6,171	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.