Information Collection

Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form

IC 191497 under ICR 201304-3041-003 · OMB 3041-0142.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3041-0142 can be found here:

Documents and Forms

Document Name Document Type
Form CPSC 120 Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form Form
CPSC 120 Compliance Verification Form FINAL VGBA Checklist - REVISED-8-24-11-OMB -3041-0142 (2).doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form	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	CPSC 120	Compliance Verification Form	FINAL VGBA Checklist - REVISED-8-24-11-OMB -3041-0142 (2).doc		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 97	Number of Respondents for Small Entity: 97

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	97	-603	700
Annual IC Time Burden (Hours)	291	-1,809	2,100
Annual IC Cost Burden (Dollars)	0	-99,624	99,624

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.