Information Collection

EERE Environmental Questionnaire - Private

IC 211748 under ICR 201708-1910-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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

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 EERE Environmental Questionnaire-Final.docx www.eere-pmc.energy.gov/NEPA.aspx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	EERE Environmental Questionnaire - Private	Agency IC Tracking Number:	Lisa Jorgensen (EERE)

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection 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 Questionniare	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 %

	Approved	Previously Approved
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

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.