Information Collection

Accidental Release Report

IC 241088 under ICR 202004-3301-001 · OMB 3301-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3301-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CSB Report Form-1 Accidental Release Report and Instructions Accidental Release Report	Form and Instruction
CSB Report Form-1 Accidental Release Report and Instructions Reportformandinstructions12-12-19.pdf	Form and Instruction

IC Title:

Accidental Release Report

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 1604

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
Form and Instruction	CSB Report Form-1				No		Fillable Fileable

Line of Business: Disaster Management

Subfunction: Disaster Monitoring and Prediction

Privacy Act System of Records

Title: not applicable

FR Citation: 40 FR 1604

Number of Respondents: 200

Number of Respondents for Small Entity: 150

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	1,860	1,860

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.

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