Information Collection

Recordkeeping by Federally-Certified Commercial Applicators in Indian Country

IC 183103 under ICR 202209-2070-004 · OMB 2070-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0029 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 8500-17 Recordkeeping by Federally-Certified Commercial Applicators in Indian Country	Form and Instruction
8500-17 Request for Pesticide Applicator Certification in Indian Form 8500-17 Fed-cert-plan.pdf	Form and Instruction
8500-17-N Request for Pesticide Applicator Certification in Navajo Form 8500-17-N.pdf	Form and Instruction
8500-17-N-Instr. Instructions for 8500-17-N Form 8500-17-N-instr.pdf	Form and Instruction

IC Title:

Recordkeeping by Federally-Certified Commercial Applicators in Indian Country

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 171.11

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	8500-17	Request for Pesticide Applicator Certification in Indian Country	Form 8500-17 Fed-cert-plan.pdf	Yes	No	Fillable Printable
Form and Instruction	8500-17-N	Request for Pesticide Applicator Certification in Navajo	Form 8500-17-N.pdf	Yes	No	Fillable Printable
Form and Instruction	8500-17-N-Instr.	Instructions for 8500-17-N	Form 8500-17-N-instr.pdf	Yes	No	Fillable Printable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 940

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	940	940
Annual IC Time Burden (Hours)	2,914	2,914
Annual IC Cost Burden (Dollars)	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.