Information Collection

CHIPS Environmental Questionnaire Information Collection

IC 258870 under ICR 202308-0693-005 · OMB 0693-0093.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
PRA Environmental Questionnaire-20230825.pdf	Other-Information Collection
PRA Environmental Questionnaire-20230825.pdf	Other-Information Collection

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
Other-Information Collection			PRA Environmental Questionnaire-20230825.pdf		Yes	Yes	Fillable Fileable

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 134

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	Previously Approved
Annual Number of Responses for this IC	134	-66	200
Annual IC Time Burden (Hours)	1,072	-528	1,600
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.