Information Collection

CDX Electronic Signature

IC 192550 under ICR 201210-2070-001 · OMB 2070-0038.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0038 can be found here:

Documents and Forms

Document Name Document Type
Form US EPA Electronic CDX Electronic Signature Form
US EPA Electronic US EPA Electronic Signature Agreement eTSCA CDX ESA - Gold Man.doc cdx.epa.gov Form
ESA and Authorizat Verification of Company Authorizing Official eTSCA CDX Verif - Gold Man.doc cdx.epa.gov Form
ESA and Authorizat Authorization And Verification For Section 5 Notice Supp eTSCA CDX Verif -Suppl - Straw Man.doc cdx.epa.gov Form
cdxguide.pdf Central Data Exchange eTSCA Registration Guide IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CDX Electronic Signature	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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	US EPA Electronic Signature Agreement	US EPA Electronic Signature Agreement	eTSCA CDX ESA - Gold Man.doc	https://cdx.epa.gov	Yes	No	Printable Only
Form	ESA and Authorization Form 1	Verification of Company Authorizing Official	eTSCA CDX Verif - Gold Man.doc	https://cdx.epa.gov	Yes	No	Printable Only
Form	ESA and Authorization Form 2	Authorization And Verification For Section 5 Notice Support Submitter By Company Authorizing Official	eTSCA CDX Verif -Suppl - Straw Man.doc	https://cdx.epa.gov	Yes	No	Printable Only

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	4	1	3
Annual IC Time Burden (Hours)	7	2	5
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Central Data Exchange eTSCA Registration Guide	cdxguide.pdf	04/12/2010

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.