Information Collection

Pesticide Safety Education Funds Management Program Customer Satisfaction Survey

IC 268110 under ICR 202404-2030-001 · OMB 2030-0051.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 9600-071 Pesticide Safety Education Funds Management Program Customer Satisfaction Survey	Form
9600-071 Customer Satisfaction Survey: PSEFMP Application Process Customer Satisfaction Survey PSEFMP.docx	Form
9600-071 Customer Satisfaction Survey: PSEFMP Application Process Customer Satisfaction Survey PSEFMP.docx	Form
Revised Request for Approval Survey PSEFMP.docx Justification	IC Document
Revised Request for Approval Survey PSEFMP.docx Justification	IC Document

IC Title:

Agency IC Tracking Number:

2434.262

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	9600-071	Customer Satisfaction Survey: PSEFMP Application Process	Customer Satisfaction Survey PSEFMP.docx		Yes	Yes	Fillable Fileable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 56

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	56	56
Annual IC Time Burden (Hours)	5	5
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification	Revised Request for Approval Survey PSEFMP.docx	05/30/2024

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