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Federal forms, ICRs, and supporting documents

OMB control number

Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form

OMB 3041-0142 · CPSC.

OMB 3041-0142

CPSC staff will fill in the form during the course of a pool and spa inspection to determine if the swimming pool and spa drain cover meets the requirements of ANSI/APSP 16 2017.

The latest form for Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form expires 2029-05-31 and is listed under ICR 202603-3041-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form CPSC 120 Compliance Verification FormForm
Form CPSC 120 Compliance Verification FormForm
PoolSpaDrainSafetyCover_Supporting_Statement_2026_cleared.docxSupporting Statement A
PoolSpaDrainSafetyCover_Supporting_Statement_2026_cleared.docxSupporting Statement A
Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form Form
Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form Form
Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form Form

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202603-3041-001 Extension without change of a currently approved collection 2026-03-30
202211-3041-003 Extension without change of a currently approved collection 2022-11-14 Approved without change
202110-3041-001 No material or nonsubstantive change to a currently approved collection 2021-10-25 Approved without change
201909-3041-001 Extension without change of a currently approved collection 2019-09-05 Approved without change
201607-3041-001 Revision of a currently approved collection 2016-07-22 Approved without change
201304-3041-003 Revision of a currently approved collection 2013-07-10 Approved without change
201108-3041-001 No material or nonsubstantive change to a currently approved collection 2011-09-06 Approved without change
200912-3041-001 Existing collection in use without an OMB Control Number 2010-05-28 Approved without change