Information Collection

Form Completion

IC 249562 under ICR 202210-2070-001 · OMB 2070-0216.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 9350-1 Form Completion	Form and Instruction
6004-02_FRM_Guidance Document.docx	Instruction
6004-02_FRM_Guidance Document.docx	Instruction
9350-1 Toxics Release Inventory Form R 6004-02_ICRSupportingStmt_Form_R.pdf ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_r.pdf	Form and Instruction
9350-1 Toxics Release Inventory Form R 6004-02_ICRSupportingStmt_Form_R.pdf ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_r.pdf	Form and Instruction
9350-2 Toxics Release Inventory Form A 6004-02_ICRSupportingStatement_Form_A.pdf ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_a.pdf	Form and Instruction
9350-2 Toxics Release Inventory Form A 6004-02_ICRSupportingStatement_Form_A.pdf ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_a.pdf	Form and Instruction
9350-3 Toxic Release Inventory Form R Schedule 1 6004-02_ICRSupportingStmt_Form_R_Schedule_1.pdf ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_a.pdf	Form and Instruction
9350-3 Toxic Release Inventory Form R Schedule 1 6004-02_ICRSupportingStmt_Form_R_Schedule_1.pdf ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_a.pdf	Form and Instruction

IC Title:

Form Completion

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 372

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	9350-1	Toxics Release Inventory Form R	6004-02_ICRSupportingStmt_Form_R.pdf	https://ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_r.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	9350-2	Toxics Release Inventory Form A	6004-02_ICRSupportingStatement_Form_A.pdf	https://ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_a.pdf	Yes	Yes	Fillable Fileable Signable
Form and Instruction	9350-3	Toxic Release Inventory Form R Schedule 1	6004-02_ICRSupportingStmt_Form_R_Schedule_1.pdf	https://ordspub.epa.gov/ords/guideme_ext/guideme_ext/guideme/file/ry_2020_form_a.pdf	Yes	Yes	Fillable Fileable Signable
Instruction			6004-02_FRM_Guidance Document.docx		Yes	No	Printable Only

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 21,154

Number of Respondents for Small Entity: 7,653

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	76,815	76,815
Annual IC Time Burden (Hours)	7,256	7,256
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.