Information Collection

EERE Environmental Questionnaire - Limited

IC 211747 under ICR 202011-1910-002 · OMB 1910-5175.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1910-5175 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form DOE F 540 EERE Environmental Questionnaire	Form and Instruction
DOE F 540 Environmental Questionnaire DOE F 540 - Environmental Questionnaire.docx	Form and Instruction
DOE F 540 Environmental Questionnaire DOE F 540 - Environmental Questionnaire.docx	Form and Instruction

IC Title:

EERE Environmental Questionnaire - Limited

Agency IC Tracking Number:

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	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	DOE F 540	Environmental Questionnaire	DOE F 540 - Environmental Questionnaire.docx		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 45

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

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

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	45	-15	60
Annual IC Time Burden (Hours)	23	-7	30
Annual IC Cost Burden (Dollars)	1,518	1,518	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.