Information Collection

PESP Memebership Application

IC 207866 under ICR 202108-2070-003 · OMB 2070-0188.

Documents and Forms

Documents and forms in this information collection
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

IC Title:

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	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 %

table that charts list of burden
	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

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.