Information Collection

Community members

IC 213376 under ICR 201811-2050-007 · OMB 2050-0211.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2050-0211 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2470.01 Questionnaire 10.28.15.docx	Other-Questionnaire

IC Title:

Community members

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

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
Other-Questionnaire			2470.01 Questionnaire 10.28.15.docx		No		Paper Only

Line of Business: Environmental Management

Subfunction: Environmental Remediation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 62

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	250	250
Annual IC Time Burden (Hours)	250	250
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.