Information Collection

Information collection for sample distribution

IC 221701 under ICR 201605-0648-003 · OMB 0648-0734.

Documents and Forms

Document Name Document Type
Information collection for sample distribution Form
List of places DWH sample availability announcement was posted.docx Other-posting information
Sample request form DWH Sample Request Form_5-20-16_clean.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Information collection for sample distribution	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	NA	Sample request form	DWH Sample Request Form_5-20-16_clean.docx		Yes	No	Fillable Printable
Other-posting information			List of places DWH sample availability announcement was posted.docx		Yes	No	Printable Only

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 75

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

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	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.