Information Collection

Emissions Value Request Form

IC 266811 under ICR 202404-1910-003 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Emissions Value Re Emissions Value Request Form	Form
20240220 Emissions Value Sheet Instructions_wFEEDstudy.docx	Other-Instruction
20240220 Emissions Value Sheet Instructions_wFEEDstudy.docx	Other-Instruction
PortalScreenshot.png	Other-Portal Screenshot
PortalScreenshot.png	Other-Portal Screenshot
Emissions Value Re Emissions Value Request Form 20240410 Emissions Value Request Form.xlsx	Form
Emissions Value Re Emissions Value Request Form 20240913 Emissions Value Request Form_clean.xlsx	Form

IC Title:

Agency IC Tracking Number:

Amelia Whiting

Is this a Common Form? No

IC Status: New

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	Emissions Value Request Form	Emissions Value Request Form	20240913 Emissions Value Request Form_clean.xlsx	Yes	Yes	Fillable Fileable
Other-Instruction			20240220 Emissions Value Sheet Instructions_wFEEDstudy.docx	Yes	No	Printable Only
Other-Portal Screenshot			PortalScreenshot.png	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: 100

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 New Statute
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	4,000	4,000
Annual IC Cost Burden (Dollars)	386,840	386,840

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.