OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Customer Satisfaction Surveys for feedback on the EJ TCTACs

IC 268115 under ICR 202404-2030-001 · OMB 2030-0051.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Form
Form
Form
Form
IC Document
IC Document
Information Collection (IC) Details

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Customer Satisfaction Surveys for feedback on the EJ TCTACs 2434.264
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form 5800-091 EJ TCTAC Intake Form Center A Center A_Northwest Environmental Justice Center.docx Yes Yes Fillable Fileable
Form 5800-092 EJ TCTAC Intake Form Center B Center B_EAGLE.docx Yes Yes Fillable Fileable
Form 5800-093 EJ TCTAC Intake Form Center C Center C_NIHB.docx Yes Yes Fillable Fileable

Environmental Management Environmental Monitoring and Forecasting

 

1,500 1,500
   
Individuals or Households
 
   100 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 1,500 0 1,500 0 0 0
Annual IC Time Burden (Hours) 375 0 375 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Justification EJ TCTACs Survey IC Justification.docx 05/30/2024
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.