PESP Memebership Application

Pesticide Environmental Stewardship Program Annual Measures Reporting (Renewal)

Documents and Forms

Document Name Document Type
Form 9600-02 PESP Memebership Application Form and Instruction
9600-02 PESP Membership Application 2415-03_Attachment E_EPA Form 9600-02 PESP Membership Application_2016-11-11.pdf www.epa.gov/pesp/forms/pesp-application-form Form and Instruction

Information Collection (IC) Details

IC Title:	PESP Memebership Application	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	9600-02	PESP Membership Application	2415-03_Attachment E_EPA Form 9600-02 PESP Membership Application_2016-11-11.pdf	https://www.epa.gov/pesp/forms/pesp-application-form	Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 80 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	12	-11	23
Annual IC Time Burden (Hours)	1,469	-1,153	2,622
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

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.