Information Collection

6:2 fluorotelomer sulfonamide betaine (CASRN 34455-29-3)

IC 254008 under ICR 202203-2070-001 · OMB 2070-0033.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0033 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
9828-01_TestOrder_ToOMB.pdf	Other-Test Order
Supplemental SS TO 34455-29-3 - revised.docx Test Order Justification Document	IC Document

IC Title:

6:2 fluorotelomer sulfonamide betaine (CASRN 34455-29-3)

Agency IC Tracking Number:

1139.46

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 790

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
Other-Test Order					Yes	Yes	Fillable Fileable Signable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	4	4
Annual IC Time Burden (Hours)	712	712
Annual IC Cost Burden (Dollars)	1,423,964	1,423,964

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Test Order Justification Document		06/02/2022

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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