Information Collection

EM Service Provider - EM System Certification Form

IC 237161 under ICR 202005-0648-006 · OMB 0648-0785.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0648-0785 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
EM Service Provider - EM System Certification Form	Form
EM System Certification Form EM System Certification Form.docx	Form

IC Title:

EM Service Provider - EM System Certification Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 50 CFR 660.603(k)(1)(v)

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	NA	EM System Certification Form	EM System Certification Form.docx		Yes	No	Fillable Printable

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5

Number of Respondents for Small Entity: 5

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	58	58
Annual IC Time Burden (Hours)	29	29
Annual IC Cost Burden (Dollars)	38	38

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.