Information Collection

EERE Environmental Questionnaire - Private

IC 211748 under ICR 201405-1910-001 · OMB 1910-5175.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5175 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOE F 540 EERE Environmental Questionnaire - Private	Form and Instruction
DOE F 540 Office of Energy Efficiency and Renewable Energy Environ 2014-08-08_EERE Environmental Questionnaire-final.docx www.eere-pmc.energy.gov/NEPA.aspx	Form and Instruction

IC Title:

EERE Environmental Questionnaire - Private

Agency IC Tracking Number:

Lisa Jorgensen (EERE)

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

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 and Instruction	DOE F 540	Office of Energy Efficiency and Renewable Energy Environmental Questionnaire	2014-08-08_EERE Environmental Questionnaire-final.docx	https://www.eere-pmc.energy.gov/NEPA.aspx	Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 240

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	240	240
Annual IC Time Burden (Hours)	120	120
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.