Information Collection

CHIPS Environmental Questionnaire Information Collection

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

Documents and Forms

Document Name Document Type
PRA Environmental Questionnaire-20230825.pdf Other-Information Collection
PRA Environmental Questionnaire-20230825.pdf Other-Information Collection

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	CHIPS Environmental Questionnaire Information Collection	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:

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 %

	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

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.