Attachment C

ATTACHMENT C

Safer Choice Program: Form for Adding Third-Party Partners and Products

(Private Label Companies, Licensees, or Toll Manufacturers)

OMB Control No. 2070-0178

Approval expires XX/XX/XX

The public reporting and recordkeeping burden for this collection of information is estimated to average 29.5 hours per response for formulators of cleaning and non-cleaning products and 9.5 hours per response for partners wishing to add third-party partners and products, including the time for reviewing instructions, gathering information, and completing and reviewing the application. Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed application to this address.

Note that this form will be incorporated into the Salesforce system in the coming months. The fields in the online form in Salesforce will be identical to the PDF form. Until this part of the system is fully incorporated, the Agency will continue to use this PDF application form.