Information Collection

Promise to Address Comprehensive Toxics (PACT) Act Outreach survey

IC 259612 under ICR 202503-2900-010 · OMB 2900-0876.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2900-0876 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Promise to Address Promise to Address Comprehensive Toxics (PACT) Act Outreach survey	Form and Instruction
Form Promise to Address Promise to Address Comprehensive Toxics (PACT) Act Outreach survey Promise to Address Comprehensive Toxics (PACT) Act Outreach survey	Form and Instruction
Promise to Address Promise to Address Comprehensive Toxics (PACT) Act Outre Wireframe PACT Outreach.docx	Form and Instruction
Promise to Address Promise to Address Comprehensive Toxics (PACT) Act Outre Wireframe PACT Outreach.docx	Form and Instruction
A-11 Fast-Track Clearance Request Template_PACT Act Outreach Survey.pdf A-11 Fast-Track Clearance Request Template PACT Act Outreach Survey	IC Document
A-11 Fast-Track Clearance Request Template_PACT Act Outreach Survey.pdf A-11 Fast-Track Clearance Request Template PACT Act Outreach Survey	IC Document

IC Title:

Promise to Address Comprehensive Toxics (PACT) Act Outreach survey

Agency IC Tracking Number:

2900-0876 Promise to Address Comprehensive Toxics

IC Status: Unchanged

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 and Instruction	Promise to Address Comprehensive Toxics (PACT) Act				Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100,000

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	Previously Approved
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	8,333	8,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
A-11 Fast-Track Clearance Request Template PACT Act Outreach Survey		04/10/2023

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

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