Information Collection

Overtime and Holiday Inspection Fees for Small and Very Small Establishments

IC 247113 under ICR 202510-0583-001 · OMB 0583-0185.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5200-16 Overtime and Holiday Inspection Fees for Small and Very Small Establishments	Form and Instruction
Form 5200-16 Overtime Holiday Rate Reduction Form Overtime and Holiday Inspection Fees for Small and Very Small Establishments	Form and Instruction
5200-16 Overtime Holiday Rate Reduction Form FSIS 5200-16 overtime and holiday rate reduction (10.27.25 fillable).pdf	Form and Instruction
5200-16 Overtime Holiday Rate Reduction Form FSIS 5200-16 overtime and holiday rate reduction (10.27.25 fillable).pdf	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	5200-16				Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,944

Number of Respondents for Small Entity: 3,944

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,944	3,944
Annual IC Time Burden (Hours)	724	724
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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

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