Information Collection

Self-Identification and Certification

IC 233592 under ICR 202211-2070-001 · OMB 2070-0208.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0208 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Notice of TSCA Fee Self-Identification and Certification	Form
Notice of TSCA Fee 9600-008 2569.01_SS_Attachment-2_Reporting Form_2018-10-19.docx	Form
Notice of TSCA Fee 9600-008 2569.01_SS_Attachment-2_Reporting Form_2018-10-19.docx	Form

IC Title:

Self-Identification and Certification

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 700, 720, 723, 725, 790, 791 (To search for a specific CFR, visit the Code of Federal Regulations.)

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	Notice of TSCA Fee Action Participation	9600-008	2569.01_SS_Attachment-2_Reporting Form_2018-10-19.docx		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: 115

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
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	38	-77	115
Annual IC Time Burden (Hours)	95	-1	96
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.