Information Collection

DSIMB Helpdesk Survey

IC 268084 under ICR 202404-2030-001 · OMB 2030-0051.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5800-010 DSIMB Helpdesk Survey	Form
5800-010 DSIMB Helpdesk Survey Questions DSIMB Helpdesk Survey Questions.docx	Form
5800-010 DSIMB Helpdesk Survey Questions DSIMB Helpdesk Survey Questions.docx	Form
Justification_DSIMB Helpdesk Survey .docx Justification	IC Document
Justification_DSIMB Helpdesk Survey .docx Justification	IC Document

IC Title:

Agency IC Tracking Number:

2434.238

IC Status: New

Obligation to Respond: Voluntary

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
Form	5800-010	DSIMB Helpdesk Survey Questions	DSIMB Helpdesk Survey Questions.docx		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Environmental Remediation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	133	133
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	Justification_DSIMB Helpdesk Survey .docx	05/30/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.