Information Collection

Application for Federal Pesticide Applicator Certification in Indian Country

IC 183102 under ICR 201301-2070-001 · OMB 2070-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0029 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8500-17-N Application for Federal Pesticide Applicator Certification in Indian Country	Form and Instruction
8500-17-N Request for Pesticide Applicator Certification in Navajo 0155.10_Attachment_F-Form8500-17-N_PAC_in_Navajo_Country.pdf www.epa.gov/oppfead1/safety/applicators/2007/8500-17-N-form.pdf	Form and Instruction
8500-17-tbd Request for Pesticide Applicator Certification in Indian 0155.10_Attachment_G-Form8500-17tbd_PAC_in_Indian_Country.pdf	Form and Instruction

IC Title:

Application for Federal Pesticide Applicator Certification in Indian Country

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 171.11

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 and Instruction	8500-17-N	Request for Pesticide Applicator Certification in Navajo Indian Country	0155.10_Attachment_F-Form8500-17-N_PAC_in_Navajo_Country.pdf	http://www.epa.gov/oppfead1/safety/applicators/2007/8500-17-N-form.pdf	Yes	No	Fillable Printable
Form and Instruction	8500-17-tbd	Request for Pesticide Applicator Certification in Indian Country	0155.10_Attachment_G-Form8500-17tbd_PAC_in_Indian_Country.pdf	tbd	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: 2,767

Number of Respondents for Small Entity: 2,767

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,767	2,767
Annual IC Time Burden (Hours)	470	470
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.