Information Collection

CSB Accidental Release Form

IC 241475 under ICR 202405-3301-002 · OMB 3301-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3301-0001 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OMB No. 3301-0001 CSB Accidental Release Form	Form
Accidental Release Reporting form instructions_revised_2021.02.19_(2).pdf www.csb.gov/assets/1/6/instructions_revised_2021.02.19_(2).pdf	Instruction
OMB No. 3301-0001 CSB Accidental Release Form Accidental Release Reporting formrevised_2021.02.19_fillable.pdf www.csb.gov/assets/1/6/formrevised_2021.02.19_fillable.pdf	Form
OMB No. 3301-0001 CSB Accidental Release Reporting Form EXHIBIT 4 ARRR FORM 2024.05.14.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

IC Status:

Obligation to Respond:

CFR Citation:

Information Collection Instruments:

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Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business:

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents:

Number of Respondents for Small Entity:

Affected Public:

Percentage of Respondents Reporting Electronically:

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		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
Annual IC Time Burden (Hours)
Annual IC Cost Burden (Dollars)

Documents for IC

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