Information Collection

CSB Accidental Release Form

IC 241475 under ICR 202101-3301-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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 Form 2020-01 CSB Accidental Release Form	Form and Instruction
Instructions Revised 2021.02.11.docx	Instruction
CSB Form 2020-01 CSB Accidental Release Form Instructionsonly12-11-19revised4-21.docx	Form and Instruction
CSB Form 2020-01 CSB Accidental Release Form FormRevised 2021.02.11.docx	Form

IC Title:

CSB Accidental Release Form

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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	CSB Form 2020-01	CSB Accidental Release Form	FormRevised 2021.02.11.docx		No		Printable Only
Instruction			Instructions Revised 2021.02.11.docx		No		Printable Only

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: 201

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
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	201	200	1
Annual IC Time Burden (Hours)	50	50	0
Annual IC Cost Burden (Dollars)	1,860	1,860	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.