Information Collection

MBNQA Examiner Application & Checklist

IC 218276 under ICR 201906-0693-002 · OMB 0693-0006.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0693-0006 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
2019 Examiner Application Screenshots rev.pdf	Other-MBNQA Examiner Application & C
SORN Dept. 18.docx SORN Commerce/Dept-18	IC Document
SORN Dept. 23.docx SORN Commerce/Dept-23	IC Document
Privacy Act Statement.docx Privacy Act Statement	IC Document

IC Title:

MBNQA Examiner Application & Checklist

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-MBNQA Examiner Application & Checklist			2019 Examiner Application Screenshots rev.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title: SORN Commerce/Dept-18 and Dept-23

FR Citation: 72 FR 6200

Number of Respondents: 550

Number of Respondents for Small Entity: 0

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	550	550
Annual IC Time Burden (Hours)	275	275
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.