Information Collection

Quality Samples Program

IC 227658 under ICR 202011-0551-001 · OMB 0551-0047.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0551-0047 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
QSP Proposal Submission 11-24-20.pdf	Instruction
QSP Proposal Submission 11-24-20.pdf	Instruction
Submitting Reports via UES.pdf.pdf	Instruction
Submitting Reports via UES.pdf.pdf	Instruction
UES Upgrade User Manual_Claims Only.pdf	Instruction
UES Upgrade User Manual_Claims Only.pdf	Instruction

IC Title:

Quality Samples Program

Agency IC Tracking Number:

QSP-2017

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	QSP Proposal Submission 11-24-20.pdf	Yes	Yes	Fillable Fileable
Instruction	Submitting Reports via UES.pdf.pdf	Yes	Yes	Fillable Fileable
Instruction	UES Upgrade User Manual_Claims Only.pdf	Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: Global Trade

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Not-for-profit institutions, Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	250	0	250
Annual IC Time Burden (Hours)	1,200	100	1,100
Annual IC Cost Burden (Dollars)	0	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.