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No active collections for this agency No active collections for this agency OMB NO: 0412-0003 EXPIRATION DATE: 12/31/2001 RESPS:56 HOURS:1,344 COSTS(000):$0 Annual Estimate of Requirements (AER) Fiscal Year -- Public Law 480, Title II Commodities FORMS: AID-1550-3 OMB NO: 0412-0004 EXPIRATION DATE: 08/31/2002 RESPS:750 HOURS:375 COSTS(000):$4 Application for Approval of Commodity Eligibility FORMS: FORM-AID-11 OMB NO: 0412-0011 EXPIRATION DATE: 12/31/2003 RESPS:85 HOURS:1,020 COSTS(000):$0 Application for Assistance - American Schools and Hospitals FORMS: AID-1010-2 OMB NO: 0412-0017 EXPIRATION DATE: 06/30/2003 RESPS:216 HOURS:126 COSTS(000):$0 Contractor's Certificate with the Agency for International Development--Contractor's Invoice--Contract Abstract FORMS: FORM-AID-1440-3 OMB NO: 0412-0020 EXPIRATION DATE: 06/30/2003 RESPS:300 HOURS:196 COSTS(000):$0 Supplier's Certificate and Agreement with the Agency for International Development for Project Commodities/Invoice--and-- Contract FORMS: FORM-AID-1450-4 OMB NO: 0412-0035 EXPIRATION DATE: 07/31/2003 RESPS:442 HOURS:1,320 COSTS(000):$0 USAID FOrm 1550-2 Private and Voluntary Organization Annual Return FORMS: 1550-2 OMB NO: 0412-0506 EXPIRATION DATE: 03/31/2002 RESPS:1,000 HOURS:1,000 COSTS(000):$0 Vendor Data Base (Formerly Known as ACRIS) FORMS: 1420-50 OMB NO: 0412-0514 EXPIRATION DATE: 09/30/2003 RESPS:1,991 HOURS:869 COSTS(000):$0 AID Regulation 1-Rules and Procedures Applicable to Commodity Transactions FORMS: NONE OMB NO: 0412-0542 EXPIRATION DATE: 04/30/2001 RESPS:400 HOURS:17,866 COSTS(000):$0 Request for Advance or Reimbursement -- Form 270 FORMS: AID-1558-2 OMB NO: 0412-0543 EXPIRATION DATE: 04/30/2001 RESPS:400 HOURS:50,296 COSTS(000):$0 Financial Status Report (Form 268, and 269 Worksheet) FORMS: AID-1558-1 AID-1558-1A OMB NO: 0412-0545 EXPIRATION DATE: 10/31/2001 RESPS:1,311 HOURS:120 COSTS(000):$0 Commodity Request for Foreign Distribution (Voluntary Agency) FORMS: 1550-4 OMB NO: 0412-0546 EXPIRATION DATE: 10/31/2001 RESPS:55 HOURS:60 COSTS(000):$0 Request for Ship of Commodities for Foreign Government FORMS: 1550-12 OMB NO: 0412-0550 EXPIRATION DATE: 01/31/2001 RESPS:656 HOURS:1,824 COSTS(000):$0 Narrative/Time-Line and Report on Commodites (Quarterly Reports) FORMS: AID-1570-13 AID-1570-14 OMB NO: 0412-0552 EXPIRATION DATE: 05/31/2001 RESPS:320 HOURS:5,920 COSTS(000):$133 Financial Status Report or Equivalent FORMS: NONE OMB NO: 0412-0553 EXPIRATION DATE: 05/31/2001 RESPS:5,000 HOURS:1,250 COSTS(000):$0 USAID Technical Consulting Services Resume Data Base FORMS: NONE OMB NO: 0412-0554 EXPIRATION DATE: 05/31/2001 RESPS:15,720 HOURS:2,620 COSTS(000):$0 Training Results and Information Network (TraiNet) FORMS: NONE OMB NO: 0412-0555 EXPIRATION DATE: 03/31/2002 RESPS:240 HOURS:24 COSTS(000):$0 Monthly Commodity Status Report/Monthly Recipient Status Report FORMS: NONE OMB NO: 0412-0556 EXPIRATION DATE: 03/31/2002 RESPS:20 HOURS:240 COSTS(000):$0 Monetization Report FORMS: NONE OMB NO: 0412-0557 EXPIRATION DATE: 03/31/2002 RESPS:20 HOURS:480 COSTS(000):$0 Annual Results Report FORMS: NONE OMB NO: 0412-0558 EXPIRATION DATE: 01/31/2001 RESPS:1,540 HOURS:11,000 COSTS(000):$4 USAID FY 2000 Population Assistance Certification FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency OMB NO: 3014-0010 EXPIRATION DATE: 01/31/2001 RESPS:201 HOURS:107,982 COSTS(000):$584,222 Telecommunications Act Accessibility Guidelines FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency No active collections for this agency OMB NO: 3037-0001 EXPIRATION DATE: 11/30/2002 RESPS:71 HOURS:142 COSTS(000):$0 Annual Certification, Qualified Nonprofit Agency Serving People Who Are Blind FORMS: 403 OMB NO: 3037-0002 EXPIRATION DATE: 11/30/2002 RESPS:552 HOURS:1,656 COSTS(000):$0 Annual Certification, Qualified Nonprofit Agency Servicing People Who Are Severely Disabled FORMS: 404 OMB NO: 3037-0003 EXPIRATION DATE: 01/31/2002 RESPS:50 HOURS:50 COSTS(000):$0 Initial Certification, Qualified Nonprofit Agency Serving People with Severe Disabilities FORMS: 402 OMB NO: 3037-0004 EXPIRATION DATE: 01/31/2002 RESPS:5 HOURS:5 COSTS(000):$0 Initial Certification, Qualified Nonprofit Agency for the Blind FORMS: 401 OMB NO: 3037-0005 EXPIRATION DATE: 09/30/2002 RESPS:650 HOURS:1,950 COSTS(000):$0 Nonprofit Agency Responsibilities FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3045-0004 EXPIRATION DATE: 10/31/2003 RESPS:100,000 HOURS:5,000 COSTS(000):$0 AmeriCorps National Referral Card FORMS: NONE OMB NO: 3045-0005 EXPIRATION DATE: 09/30/2001 RESPS:500 HOURS:1,000 COSTS(000):$0 AmeriCorps*NCCC Team Leader Application FORMS: NONE OMB NO: 3045-0006 EXPIRATION DATE: 11/30/2003 RESPS:48,000 HOURS:5,600 COSTS(000):$0 Corporation for National Service, Enrollment Form FORMS: NONE OMB NO: 3045-0010 EXPIRATION DATE: 12/31/2003 RESPS:900 HOURS:7,200 COSTS(000):$108,000 AmeriCorps*National Civilian Community Corps Service Project Application FORMS: NONE OMB NO: 3045-0014 EXPIRATION DATE: 01/31/2001 RESPS:40,000 HOURS:2,000 COSTS(000):$0 Voucher and Payment Request Form FORMS: NONE OMB NO: 3045-0015 EXPIRATION DATE: 11/30/2003 RESPS:48,000 HOURS:5,600 COSTS(000):$0 Corporation for National Service EXIT FORM FORMS: NONE OMB NO: 3045-0020 EXPIRATION DATE: 10/31/2002 RESPS:3,310 HOURS:2,364 COSTS(000):$47 AmeriCorps*VISTA Accomplishment Review FORMS: NONE OMB NO: 3045-0025 EXPIRATION DATE: 07/31/2001 RESPS:2,500 HOURS:1,250 COSTS(000):$0 AmeriCorps*National Civilian Community Corps Applicant Medical Prescreening Form FORMS: NONE OMB NO: 3045-0029 EXPIRATION DATE: 06/30/2002 RESPS:650 HOURS:4,338 COSTS(000):$11 Project Profile and Volunteer Activity Survey (PPVA); RSVP, FGP, SCP FORMS: 1021-RSVP 1021-FGP 1021-SCP OMB NO: 3045-0030 EXPIRATION DATE: 03/31/2002 RESPS:6,000 HOURS:1,000 COSTS(000):$0 Forbearance Request for National Service FORMS: NONE OMB NO: 3045-0033 EXPIRATION DATE: 05/31/2003 RESPS:2,104 HOURS:12,576 COSTS(000):$3 National Senior Service Corps Project Progress Report FORMS: A-1020 OMB NO: 3045-0035 EXPIRATION DATE: 03/31/2001 RESPS:1,463 HOURS:19,450 COSTS(000):$3 National Senior Service Corps Grant Application FORMS: 424-NSSC OMB NO: 3045-0038 EXPIRATION DATE: 04/30/2003 RESPS:2,200 HOURS:9,200 COSTS(000):$10 AmeriCorps "VISTA Project Application, Part A and Part B FORMS: 1421 1421B OMB NO: 3045-0043 EXPIRATION DATE: 07/31/2001 RESPS:3,600 HOURS:5,400 COSTS(000):$0 AmeriCorps*VISTA Project Progress Report FORMS: 1433 OMB NO: 3045-0045 EXPIRATION DATE: 02/28/2003 RESPS:1 HOURS:2,250 COSTS(000):$0 The 2000 Application Guidelines for Learn and Serve America School- and Community-Based Programs FORMS: NONE OMB NO: 3045-0046 EXPIRATION DATE: 02/28/2003 RESPS:400 HOURS:2,400 COSTS(000):$0 The 2000 Application Guidelines for Learn and Serve America Higher Education FORMS: NONE OMB NO: 3045-0047 EXPIRATION DATE: 02/28/2003 RESPS:1 HOURS:20,000 COSTS(000):$0 The 2000 Application Guidelines for AmeriCorps National, State and Indian Tribes, and U.S. Territories FORMS: NONE OMB NO: 3045-0049 EXPIRATION DATE: 08/31/2001 RESPS:3,750 HOURS:2,812 COSTS(000):$0 Senior Corps Accomplishment Surveys FORMS: NONE OMB NO: 3045-0050 EXPIRATION DATE: 09/30/2001 RESPS:500 HOURS:1,000 COSTS(000):$5 AmeriCorps Leaders Program Leader Application FORMS: NONE OMB NO: 3045-0051 EXPIRATION DATE: 01/31/2002 RESPS:250 HOURS:1,500 COSTS(000):$0 National Service-Learning Leader Schools Application FORMS: NONE OMB NO: 3045-0052 EXPIRATION DATE: 02/28/2002 RESPS:1,125 HOURS:633 COSTS(000):$0 The Evaluation of Literacy and Tutoring Programs FORMS: NONE OMB NO: 3045-0053 EXPIRATION DATE: 03/31/2002 RESPS:6,000 HOURS:1,000 COSTS(000):$0 Interest Accrued During National Service FORMS: NONE OMB NO: 3045-0054 EXPIRATION DATE: 06/30/2002 RESPS:60,000 HOURS:45,000 COSTS(000):$0 AmeriCorps Member Application FORMS: NONE OMB NO: 3045-0055 EXPIRATION DATE: 07/31/2002 RESPS:18,000 HOURS:9,000 COSTS(000):$0 Corporation for National Service Generic Customer Survey Clearance FORMS: NONE OMB NO: 3045-0056 EXPIRATION DATE: 07/31/2002 RESPS:2,100 HOURS:2,100 COSTS(000):$46 Learn and Serve America Project Description Form FORMS: NONE OMB NO: 3045-0057 EXPIRATION DATE: 08/31/2002 RESPS:7,800 HOURS:1,492 COSTS(000):$0 Senior Companion Program Quality of Care Evaluation -- Parts 1-5 FORMS: NONE OMB NO: 3045-0060 EXPIRATION DATE: 09/30/2002 RESPS:7,835 HOURS:2,671 COSTS(000):$0 Longitudinal Research on Member Outcomes FORMS: NONE OMB NO: 3045-0061 EXPIRATION DATE: 10/31/2002 RESPS:6,610 HOURS:5,130 COSTS(000):$0 Outcome Evaluation of Literacy and Tutoring Programs FORMS: NONE OMB NO: 3045-0062 EXPIRATION DATE: 10/31/2002 RESPS:68 HOURS:272 COSTS(000):$0 Program Development Assistance and Training (PDAT) Budget Form FORMS: NONE OMB NO: 3045-0064 EXPIRATION DATE: 02/28/2003 RESPS:14 HOURS:4,760 COSTS(000):$0 State Administrative Standards FORMS: NONE OMB NO: 3045-0065 EXPIRATION DATE: 02/28/2003 RESPS:300 HOURS:2,400 COSTS(000):$0 AmeriCorps Education Awards Program 2000 Application Guidelines FORMS: NONE OMB NO: 3045-0067 EXPIRATION DATE: 05/31/2003 RESPS:1,304 HOURS:978 COSTS(000):$0 National Senior Service Corps (NSSC) Government Performance and Results Act (GPRA) Project Data Report FORMS: NONE OMB NO: 3045-0068 EXPIRATION DATE: 06/30/2003 RESPS:319 HOURS:156 COSTS(000):$0 Evaluation of the Accomplishments and Outcomes of AmeriCorps*NCCC Projects FORMS: NONE OMB NO: 3045-0069 EXPIRATION DATE: 09/30/2001 RESPS:66 HOURS:1,650 COSTS(000):$1,347 2000 AmeriCorps Promise Fellows Continuation Application Instructions FORMS: NONE OMB NO: 3045-0070 EXPIRATION DATE: 08/31/2003 RESPS:3,456 HOURS:3,831 COSTS(000):$0 Long-term Study of Member Outcomes FORMS: NONE OMB NO: 3045-0071 EXPIRATION DATE: 09/30/2003 RESPS:100 HOURS:1,000 COSTS(000):$2 Outreach to Individuals with a Disability to Increase their Participation in National Service Application Guidelines FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency OMB NO: 2010-0026 EXPIRATION DATE: 02/28/2002 RESPS:15 HOURS:233,770 COSTS(000):$23 Amendment to Regulatory Reinvention Pilot Projects (Project XL) FORMS: 1755.03 OMB NO: 2010-0029 EXPIRATION DATE: 01/31/2001 RESPS:13,095 HOURS:7,820 COSTS(000):$0 Environmental Information Customer Survey FORMS: 1853.01 OMB NO: 2010-0030 EXPIRATION DATE: 07/31/2002 RESPS:167 HOURS:458 COSTS(000):$0 National Roster for Environmental Dispute Resolution and Consensus-Building Professionals FORMS: 1888.01 OMB NO: 2010-0032 EXPIRATION DATE: 06/30/2003 RESPS:200 HOURS:50,450 COSTS(000):$0 Performance Track Program Level One: The Environmental Achieve- ment Track FORMS: 1949.01 Office of Environmental Education No active collections for this subagency Office of Enforcement and Compliance Assurance OMB NO: 2020-0003 EXPIRATION DATE: 09/30/2003 RESPS:1,101 HOURS:6,432 COSTS(000):$0 Confidentiality Rules FORMS: 1665.03 OMB NO: 2020-0007 EXPIRATION DATE: 09/30/2001 RESPS:12 HOURS:980 COSTS(000):$0 Environmental Impact Assessment of Nongovernmental Activities in Antarctica FORMS: 1808.02 OMB NO: 2020-0015 EXPIRATION DATE: 09/30/2001 RESPS:155,197 HOURS:19,470 COSTS(000):$0 Agency Generic Information Collection Request, Regional Compliance Assistance Program Evaluation FORMS: 1860.01 OMB NO: 2020-0017 EXPIRATION DATE: 07/31/2002 RESPS:193 HOURS:11,391 COSTS(000):$0 Star Track Program FORMS: 1825.01 OMB NO: 2020-0020 EXPIRATION DATE: 03/31/2001 RESPS:55 HOURS:11,440 COSTS(000):$0 Public Water Systems Annual Compliance Report FORMS: NONE Office of Environmental Information No active collections for this subagency Administration and Resources Management OMB NO: 2030-0005 EXPIRATION DATE: 02/28/2003 RESPS:4,884 HOURS:177,045 COSTS(000):$49 Monthly Progress Reports FORMS: 1039.09 OMB NO: 2030-0006 EXPIRATION DATE: 01/31/2001 RESPS:1,731 HOURS:399,342 COSTS(000):$0 Invitation for Bids and Request for Proposals FORMS: 1038.09 OMB NO: 2030-0007 EXPIRATION DATE: 02/28/2003 RESPS:37,492 HOURS:9,373 COSTS(000):$0 Oral and Written Purchase Orders FORMS: 1900-8 1900-13 1037.06 OMB NO: 2030-0016 EXPIRATION DATE: 02/28/2003 RESPS:65 HOURS:43 COSTS(000):$0 Contractor Cumulative Claim and Reconciliation FORMS: 1900-10 0246.07 OMB NO: 2030-0020 EXPIRATION DATE: 12/31/2002 RESPS:4,623 HOURS:142,435 COSTS(000):$0 General Administrative Requirements for Assistance Programs FORMS: 0938.07 OMB NO: 2030-0023 EXPIRATION DATE: 01/31/2001 RESPS:10,200 HOURS:207,450 COSTS(000):$0 Conflict of Interest FORMS: 1550.04 OMB NO: 2030-0037 EXPIRATION DATE: 03/31/2001 RESPS:103 HOURS:695 COSTS(000):$0 Obtaining Unbilled Grant Expenses from Grant Recipients at Year-End FORMS: 1810.01 OMB NO: 2030-0038 EXPIRATION DATE: 09/30/2001 RESPS:500 HOURS:5,000 COSTS(000):$0 Cooperative Agreements and Superfund Contracts for Superfund Response Actions FORMS: 1487.06 OMB NO: 2030-0039 EXPIRATION DATE: 12/31/2002 RESPS:8,100 HOURS:24,559 COSTS(000):$0 Synopses of Proposed Contract Actions and Market Research Activity FORMS: 1910.01 OMB NO: 2030-0041 EXPIRATION DATE: 11/30/2002 RESPS:240 HOURS:12 COSTS(000):$0 Business Ownership Representation FORMS: 1962.01 Water OMB NO: 2040-0004 EXPIRATION DATE: 09/30/2001 RESPS:611,235 HOURS:13,324,546 COSTS(000):$0 Standards for the Use or Disposal of Sewage Sludge FORMS: 0229.13 OMB NO: 2040-0009 EXPIRATION DATE: 09/30/2003 RESPS:2,028,826 HOURS:2,847,167 COSTS(000):$0 Information Collection Request for the National Pretreatment Program FORMS: 0002.09 OMB NO: 2040-0027 EXPIRATION DATE: 03/31/2003 RESPS:280 HOURS:76,752 COSTS(000):$0 Construction Grants Program Information Collection Request FORMS: 0827.05 OMB NO: 2040-0042 EXPIRATION DATE: 09/30/2001 RESPS:438,048 HOURS:1,135,273 COSTS(000):$27,649 Underground Injection Control Program FORMS: 370.16 7520-1 7520-4 7520-6 7520-12 7520-14 7520-16 OMB NO: 2040-0049 EXPIRATION DATE: 07/31/2002 RESPS:83 HOURS:190,336 COSTS(000):$0 Water Quality Standards Regulation -- 40 CFR Part 131 FORMS: 988.07 OMB NO: 2040-0050 EXPIRATION DATE: 12/31/2001 RESPS:14,291 HOURS:21,000 COSTS(000):$6 Clean Water Needs Survey FORMS: 0318.08 OMB NO: 2040-0057 EXPIRATION DATE: 04/30/2003 RESPS:23,086 HOURS:1,140,794 COSTS(000):$0 Pollutant Discharge Elimination System and Sewage Sludge Management State Programs FORMS: 0168.07 OMB NO: 2040-0068 EXPIRATION DATE: 04/30/2003 RESPS:15,594 HOURS:293,323 COSTS(000):$0 National Pollutant Discharge Elimination System (NPDES) Modification and Variance Requests FORMS: 0029.07 OMB NO: 2040-0071 EXPIRATION DATE: 07/31/2003 RESPS:59 HOURS:4,489,147 COSTS(000):$0 National Water Quality Inventory Reports (TMDL Final Rule: Clean Water Act Sections 305(b), 303(d), 314(a) and 106(e)). FORMS: 1560.06 OMB NO: 2040-0086 EXPIRATION DATE: 04/30/2003 RESPS:88,209 HOURS:2,038,694 COSTS(000):$1,005 Applications for NPDES Discharge Permits and the Sewage Management Permits FORMS: 0226.15 OMB NO: 2040-0088 EXPIRATION DATE: 07/31/2002 RESPS:128 HOURS:71,049 COSTS(000):$0 Modification of Secondary Treatment Requirements for Discharges into Marine Waters FORMS: 0138.06 OMB NO: 2040-0090 EXPIRATION DATE: 09/30/2001 RESPS:8,665 HOURS:9,531,172 COSTS(000):$180,567 Revisions to the Existing Variance and Exemptions Rule to Comply FORMS: 270.39 OMB NO: 2040-0095 EXPIRATION DATE: 03/31/2003 RESPS:111 HOURS:6,016 COSTS(000):$0 Construction Grants Delegation to States FORMS: 0909.06 OMB NO: 2040-0101 EXPIRATION DATE: 01/31/2001 RESPS:200 HOURS:2,800 COSTS(000):$0 Questionnaries for Reviewing Operations and Maintenance (O&M), Biosolids Use (Biosolids), Combined Sewer Overflow (CSO), and Storm Water (SW) Awards Nominees under the NWMEAP FORMS: 1287.05 OMB NO: 2040-0110 EXPIRATION DATE: 01/31/2001 RESPS:205,896 HOURS:825,053 COSTS(000):$0 National Pollutant Discharge Elimination System (NPDES), FORMS: 1427.05 OMB NO: 2040-0118 EXPIRATION DATE: 09/30/2001 RESPS:1,479 HOURS:186,405 COSTS(000):$0 Clean Water Act State Revolving Fund Program FORMS: 1391.04 OMB NO: 2040-0138 EXPIRATION DATE: 04/30/2003 RESPS:41 HOURS:46,767 COSTS(000):$0 National Estuary Program FORMS: 1500.04 OMB NO: 2040-0153 EXPIRATION DATE: 04/30/2003 RESPS:29 HOURS:3,625 COSTS(000):$0 Approval of State Coastal Nonpoint Control Program -- CZARA Section 6217 FORMS: EPA-1569.04 OMB NO: 2040-0164 EXPIRATION DATE: 03/31/2003 RESPS:895 HOURS:2,556 COSTS(000):$0 Reporting Requirements under EPA's Water Alliances for Voluntary Efficiency (WAVE) Program FORMS: 1654.03 OMB NO: 2040-0168 EXPIRATION DATE: 01/31/2003 RESPS:20,005 HOURS:100,667 COSTS(000):$0 Clean Water Act Section 404 State-Assumed Programs FORMS: 0220.08 OMB NO: 2040-0170 EXPIRATION DATE: 01/31/2001 RESPS:916 HOURS:631,584 COSTS(000):$348 Combined Sewer Overflow Policy FORMS: 1680.02 OMB NO: 2040-0180 EXPIRATION DATE: 09/30/2001 RESPS:1,257 HOURS:122,863 COSTS(000):$0 National Pollutant Discharge Elimination System Great Lakes Water Quality Guidance FORMS: 1639.03 OMB NO: 2040-0185 EXPIRATION DATE: 06/30/2003 RESPS:1,377 HOURS:192,950 COSTS(000):$0 Information Collection Request for Drinking Water State Revolving Fund Programs FORMS: 1803.03 OMB NO: 2040-0187 EXPIRATION DATE: 02/28/2001 RESPS:6 HOURS:1,965 COSTS(000):$1 Establishment of No-Discharge Zones for Discharges Incidental to FORMS: 1791.02 OMB NO: 2040-0188 EXPIRATION DATE: 03/31/2003 RESPS:186,121 HOURS:4,753,452 COSTS(000):$2,045 Notice of Intent for Storm Water Discharges Associated with Construction Activity under a NPDES General Permit FORMS: 3510-9 1842.02 OMB NO: 2040-0189 EXPIRATION DATE: 01/31/2003 RESPS:533 HOURS:1,280 COSTS(000):$1 National Health Protection Survey of Beaches FORMS: 1814.02 OMB NO: 2040-0194 EXPIRATION DATE: 07/31/2001 RESPS:4,530 HOURS:3,935 COSTS(000):$0 The Class V Underground Injection Control Study FORMS: 1834.01 OMB NO: 2040-0195 EXPIRATION DATE: 09/30/2001 RESPS:56 HOURS:696 COSTS(000):$0 Public Water System Supervision Primacy Regulation FORMS: 1836.01 OMB NO: 2040-0197 EXPIRATION DATE: 01/31/2001 RESPS:165 HOURS:907,745 COSTS(000):$2,299 State Source Water Assessment and Protection Programs FORMS: EPAICR1816.01 OMB NO: 2040-0198 EXPIRATION DATE: 10/31/2001 RESPS:1,739 HOURS:15,044 COSTS(000):$0 1999 Drinking Water Infrastructure Needs Survey FORMS: 1708.02 OMB NO: 2040-0201 EXPIRATION DATE: 09/30/2001 RESPS:47,040 HOURS:459,674 COSTS(000):$20,808 Consumer Confidence Reports for Community Water Systems FORMS: 1832.02 OMB NO: 2040-0202 EXPIRATION DATE: 01/31/2002 RESPS:29 HOURS:1,302 COSTS(000):$78 Milestones Plan for the Bleached Papergrade Kraft and Soda Subcategory of the Pulp, Paper, and Paperboard Point Source Category FORMS: 1877.01 OMB NO: 2040-0203 EXPIRATION DATE: 12/31/2001 RESPS:2,600 HOURS:25,870 COSTS(000):$8 Industry Screener Questionnaire: Phase 1 Cooling Water Intake Structures FORMS: 1828.02 OMB NO: 2040-0204 EXPIRATION DATE: 11/30/2001 RESPS:9,449 HOURS:314,471 COSTS(000):$0 Information Collection Request for Final National Primary Drink- ducts Rule FORMS: 1896.01 OMB NO: 2040-0205 EXPIRATION DATE: 11/30/2001 RESPS:3,803 HOURS:150,557 COSTS(000):$22,832 Title Information Collection Request for Final National Primary Treatment Rule FORMS: 1895.01 OMB NO: 2040-0206 EXPIRATION DATE: 01/31/2001 RESPS:960 HOURS:1,320 COSTS(000):$55 Small System Survey FORMS: 1863.01 OMB NO: 2040-0207 EXPIRATION DATE: 03/31/2002 RESPS:130 HOURS:142,369 COSTS(000):$7,255 Best Management Practices for the Bleached Papergrade Kraft and Soda Subcategory and the Papergrade Sulfite Subcategory of the Pulp, Paper, and Paperboard Point Source Category FORMS: 1829.01 OMB NO: 2040-0208 EXPIRATION DATE: 12/31/2003 RESPS:170 HOURS:11,519 COSTS(000):$3,407 Unregulated Contiminant Monitoring Regulations for Public Water systems; Analytical Methods for List 2 Contaminants (Proposed Rule) FORMS: 1882.02 OMB NO: 2040-0209 EXPIRATION DATE: 06/30/2002 RESPS:51,449 HOURS:748,811 COSTS(000):$4,035 Public Water System Supervision Program Public Notification Requirements FORMS: 1898.02 OMB NO: 2040-0210 EXPIRATION DATE: 09/30/2002 RESPS:159,929 HOURS:2,431,728 COSTS(000):$14,026 Information Collection Request: National Primary Drinking Water Regulation for Lead and Copper (Final Rule) FORMS: 1912.01 OMB NO: 2040-0211 EXPIRATION DATE: 10/31/2002 RESPS:36,421 HOURS:56,369 COSTS(000):$0 Phase II of the NPDES Storm Water Program (Final Rule ICR) FORMS: 1820.02 OMB NO: 2040-0213 EXPIRATION DATE: 12/31/2002 RESPS:1,836 HOURS:128,736 COSTS(000):$14 Industry Detailed Questionnaire: Phase II Cooling Water Intake Structures FORMS: 1838.01 OMB NO: 2040-0214 EXPIRATION DATE: 11/30/2002 RESPS:855 HOURS:21,007 COSTS(000):$418 Revisions to the Underground Injection Control Regulations for Class V Injection Wells (Final Rule) FORMS: 1874.02 OMB NO: 2040-0216 EXPIRATION DATE: 09/30/2003 RESPS:20 HOURS:3,603 COSTS(000):$0 Information Collection Request for the State Water Quality Pro- gram management Gap Analysis. FORMS: 1945.01 OMB NO: 2040-0228 EXPIRATION DATE: 11/30/2003 RESPS:33 HOURS:342,873 COSTS(000):$0 Information Collection Request for National Primary Drinking Water Regulations: Radionuclides FORMS: 1972.01 Solid Waste and Emergency Response OMB NO: 2050-0009 EXPIRATION DATE: 03/31/2003 RESPS:579 HOURS:177,543 COSTS(000):$48,341 Part B Permit Application, Permit Modifications, and Special Permits FORMS: 1573.06 OMB NO: 2050-0021 EXPIRATION DATE: 01/31/2001 RESPS:469,993 HOURS:2,828,150 COSTS(000):$28,743 Spill Prevention, Control, and Countermeasures (SPCC) Plans FORMS: 0328.08 OMB NO: 2050-0024 EXPIRATION DATE: 06/30/2003 RESPS:505,047 HOURS:188,624 COSTS(000):$26 The 2001 Hazardous Waste Report (Biennial Report) FORMS: 0976.10 OMB NO: 2050-0028 EXPIRATION DATE: 12/31/2002 RESPS:31,125 HOURS:96,330 COSTS(000):$131 Notification of Regulated Waste Activity FORMS: 8700 261.13 OMB NO: 2050-0033 EXPIRATION DATE: 11/30/2001 RESPS:3,796 HOURS:64,181 COSTS(000):$80,106 Facility Groundwater Monitoring Requirements FORMS: 959.10 OMB NO: 2050-0034 EXPIRATION DATE: 10/31/2002 RESPS:59 HOURS:910 COSTS(000):$0 RCRA Hazardous Waste Permit Application and Modification, Part A FORMS: 8700-23 262.09 OMB NO: 2050-0035 EXPIRATION DATE: 09/30/2001 RESPS:244,932 HOURS:549,686 COSTS(000):$1,867,304 Hazardous Waste Generator Standards FORMS: 820.07 OMB NO: 2050-0039 EXPIRATION DATE: 03/31/2002 RESPS:2,250,000 HOURS:2,920,383 COSTS(000):$1,871 Requirements for Generators, Transporters, and Hazardous Waste Management Facilities under the RCRA Hazardous Waste Manifest System FORMS: 801.12 OMB NO: 2050-0041 EXPIRATION DATE: 05/31/2002 RESPS:18 HOURS:21,357 COSTS(000):$0 Final Authorization for Hazardous Waste Management FORMS: 0969.05 OMB NO: 2050-0046 EXPIRATION DATE: 02/28/2001 RESPS:29,204 HOURS:122,360 COSTS(000):$0 Notification of Episodic Releases of Oil and Hazardous Substances FORMS: 1049.08 OMB NO: 2050-0050 EXPIRATION DATE: 12/31/2003 RESPS:6,341 HOURS:287,069 COSTS(000):$875 Hazardous Waste Specific Unit Requirements, and Special Waste processes and Types FORMS: 1572.05 OMB NO: 2050-0053 EXPIRATION DATE: 09/30/2001 RESPS:15 HOURS:19,318 COSTS(000):$1 "Identification, Listing, and Rulemaking Petition" (LDR Phase IV: FORMS: 118907 OMB NO: 2050-0062 EXPIRATION DATE: 09/30/2003 RESPS:0.33 HOURS:3,137 COSTS(000):$1 Land Disposal Restrictions No-Migration Variances FORMS: 1353.06 OMB NO: 2050-0068 EXPIRATION DATE: 09/30/2001 RESPS:5,000,000 HOURS:6,254,048 COSTS(000):$1,258,550 Underground Storage Tanks: Technical and Financial Requirements and State Program Approval Procedures FORMS: 1360.05 7530-1 OMB NO: 2050-0072 EXPIRATION DATE: 08/31/2001 RESPS:563,460 HOURS:1,873,800 COSTS(000):$6,404 Community Right-to-Know Reporting Requirements under Sections 311 and 312 of the Emergency Planning and Community Right-to-Know Act (EPCRA) FORMS: 1352.07 OMB NO: 2050-0073 EXPIRATION DATE: 10/31/2002 RESPS:1,850 HOURS:316,892 COSTS(000):$26,221 Information Collection Request for New RCRA Reporting and Recordkeeping Requirements for Incinerators, Boilers, and Industrial Furnaces Burning Hazardous Waste FORMS: 1361.08 OMB NO: 2050-0077 EXPIRATION DATE: 03/31/2001 RESPS:36 HOURS:324 COSTS(000):$0 Application for Reimbursement to Local Governments for Emergency 123. FORMS: 1425.04 OMB NO: 2050-0078 EXPIRATION DATE: 09/30/2003 RESPS:315 HOURS:3,121 COSTS(000):$0 Trade Secret Claims for Emergency Planning and Community Right-to-Know (EPCRA Section 322) FORMS: ICR-1428.05 OMB NO: 2050-0085 EXPIRATION DATE: 01/31/2001 RESPS:212,699 HOURS:3,402,862 COSTS(000):$8,648 Land Disposal Restriction (LDR Phase IV: Treatment Standards for Wastes from Toxicity Characteristic Metals, Mineral Processing Secondary Materials, and the Exclusion of Recycled Wood) FORMS: 1442.16 OMB NO: 2050-0086 EXPIRATION DATE: 03/31/2001 RESPS:18,736 HOURS:181,180 COSTS(000):$159 Continuous Release Reporting Regulations (CRRR) FORMS: 1445.04 OMB NO: 2050-0092 EXPIRATION DATE: 01/31/2003 RESPS:99,170 HOURS:251,700 COSTS(000):$64 Emergency Planning and Release Notification Requirements -- EPCRA Sections 302, 303, and 304 FORMS: 1395.04 OMB NO: 2050-0095 EXPIRATION DATE: 09/30/2001 RESPS:1,163 HOURS:203,373 COSTS(000):$0 Superfund Site Evaluation and Hazard Ranking System FORMS: 1488.04 OMB NO: 2050-0096 EXPIRATION DATE: 07/31/2001 RESPS:390 HOURS:113,490 COSTS(000):$0 National Oil and Hazardous Substances Pollution Contingency Plan (NCP) -- 40 CFR Part 300 FORMS: 1463.04 OMB NO: 2050-0105 EXPIRATION DATE: 07/31/2002 RESPS:24,000 HOURS:255,427 COSTS(000):$0 EPA Worker Protection Standard for Hazardous Waste Operations and Emergency Response FORMS: 1426.05 OMB NO: 2050-0106 EXPIRATION DATE: 04/30/2001 RESPS:17 HOURS:1,968 COSTS(000):$0 Application for Preauthorization of a CERCLA Response Action FORMS: 1304.05 OMB NO: 2050-0120 EXPIRATION DATE: 12/31/2002 RESPS:2,724 HOURS:804,467 COSTS(000):$1,374 General Hazardous Waste Facility Standards FORMS: 1571.06 OMB NO: 2050-0122 EXPIRATION DATE: 08/31/2003 RESPS:2,300 HOURS:239,858 COSTS(000):$0 Recordkeeping and Reporting Requirements for 40 CFR Part 258 - Solid Waste Disposal Facilities and Practices FORMS: 1381.06 OMB NO: 2050-0124 EXPIRATION DATE: 06/30/2002 RESPS:983 HOURS:540,582 COSTS(000):$9,510 Used Oil Management Standards Recordkeeping and Reporting Requirements FORMS: 1286.05 OMB NO: 2050-0135 EXPIRATION DATE: 01/31/2001 RESPS:9,886 HOURS:562,254 COSTS(000):$20 Oil Pollution Act Facility Response Plan Requirements. FORMS: 1630.06 1630.03 OMB NO: 2050-0139 EXPIRATION DATE: 01/31/2001 RESPS:1,105 HOURS:40,067 COSTS(000):$0 Reporting and Recordkeeping Requirements under EPA's Waste Wise Program FORMS: 1698.03 OMB NO: 2050-0141 EXPIRATION DATE: 01/31/2001 RESPS:14 HOURS:370 COSTS(000):$83,000 National Oil and Hazardous Substances Pollution Contingency Plan -- Subpart J FORMS: 1664.03 OMB NO: 2050-0143 EXPIRATION DATE: 03/31/2001 RESPS:1,208 HOURS:8,314 COSTS(000):$1 Exports From and Imports To the United States under the OECD Decision FORMS: 1647.02 OMB NO: 2050-0144 EXPIRATION DATE: 09/30/2002 RESPS:12,300 HOURS:109,800 COSTS(000):$9 Risk Management Program Requirements and Petitions to Modify the Air Act FORMS: 1656.06 OMB NO: 2050-0145 EXPIRATION DATE: 09/30/2001 RESPS:79,271 HOURS:122,674 COSTS(000):$3 Hazardous Waste Management Systems Modifications of the Hazardous Waste Recycling Regulatory Program, Standards for Universal Waste Management -- 40 CFR FORMS: 1597.03 OMB NO: 2050-0149 EXPIRATION DATE: 05/31/2002 RESPS:395 HOURS:7,253 COSTS(000):$9 RCRA Expanded Public Participation FORMS: 1688.03 OMB NO: 2050-0152 EXPIRATION DATE: 04/30/2002 RESPS:13 HOURS:6,510 COSTS(000):$0 State Program Adequacy Determination: Non-Municipal, Non-Hazardous Waste Disposal Units that Receive Conditionally Exempt Small Quatity Generator (CESQG) Hazardous Waste and MSWLFs FORMS: 1608.02 OMB NO: 2050-0154 EXPIRATION DATE: 10/31/2002 RESPS:164 HOURS:11,105 COSTS(000):$0 Criteria for Classification of Solid Waste Disposal Facilities -- RCRA-257 FORMS: 1745.03 OMB NO: 2050-0157 EXPIRATION DATE: 12/31/2001 RESPS:838 HOURS:14,794 COSTS(000):$10 Information Collection Request for the Land Disposal Restrictions Surface Impoundment Study FORMS: 1841.01 OMB NO: 2050-0159 EXPIRATION DATE: 08/31/2001 RESPS:132 HOURS:1,907 COSTS(000):$0 Survey of the Inorganic Chemicals Industry FORMS: 1848.01 OMB NO: 2050-0161 EXPIRATION DATE: 06/30/2002 RESPS:66 HOURS:34,619 COSTS(000):$50 Hazardous Remediation Waste Management Requirements (HWIR-Media) -- #1775.02 FORMS: NONE OMB NO: 2050-0162 EXPIRATION DATE: 06/30/2002 RESPS:3,300 HOURS:1,650 COSTS(000):$0 The 1999 National Survey of Local Emergency Planning Committees FORMS: 1903.01 OMB NO: 2050-0164 EXPIRATION DATE: 09/30/2002 RESPS:101,500 HOURS:127,300 COSTS(000):$2 Reporting and Recordkeeping Requirements for Generators of Hazardous Waste Lamps FORMS: 1699.02 OMB NO: 2050-0168 EXPIRATION DATE: 06/30/2001 RESPS:365 HOURS:8,250 COSTS(000):$0 Questionnaire for the Paint Manufacturing Industry -- RCRA Section 3007 FORMS: 1925.01 OMB NO: 2050-0170 EXPIRATION DATE: 02/28/2002 RESPS:161 HOURS:3,419 COSTS(000):$0 Resource Conservation and Recovery Act (RCRA) Corrective Action Information Request FORMS: 1939.01 OMB NO: 2050-0171 EXPIRATION DATE: 02/28/2003 RESPS:916 HOURS:67,978 COSTS(000):$1,611 Information Collection Request for New and Amended Reporting and Recordkeeping Requirements for National Emission Standards for Hazardous Air Pollutants from Hazardous Wast Combustors FORMS: 1773.02 OMB NO: 2050-0172 EXPIRATION DATE: 10/31/2003 RESPS:10,380 HOURS:99,518 COSTS(000):$126 Distribution of Off-site Consequence Analysis Information under Section 112(r) of the Clean Air Act. FORMS: 1981.01 OMB NO: 2050-0175 EXPIRATION DATE: 12/31/2003 RESPS:10,157 HOURS:2,590 COSTS(000):$143 The RCRA Subtitle C Site Identification Form FORMS: 2005.01 8700-13A/B Air and Radiation OMB NO: 2060-0001 EXPIRATION DATE: 01/31/2003 RESPS:105 HOURS:3,092 COSTS(000):$50 NSPS for Beverage Can Surface Coating -- 40 CFR Part 60, Subpart WW FORMS: 0663.07 OMB NO: 2060-0002 EXPIRATION DATE: 09/30/2001 RESPS:86 HOURS:15,629 COSTS(000):$3,210 NSPS for Asphalt Processing and Asphalt Roofing Manufacturers, Reporting and Recordkeeping Requirements -- Subpart UU FORMS: 0661.06 OMB NO: 2060-0003 EXPIRATION DATE: 03/31/2001 RESPS:114,820 HOURS:4,715,260 COSTS(000):$0 Prevention of Significant Deterioration Non-Attainment Area New Source Review FORMS: 1230.09 OMB NO: 2060-0004 EXPIRATION DATE: 01/31/2003 RESPS:1,025 HOURS:39,104 COSTS(000):$1,880 Pressure-Sensitive Tape and Lable Surface Coating Operations, Information Request -- NSPS Subpart RR FORMS: 0658.07 OMB NO: 2060-0006 EXPIRATION DATE: 09/30/2002 RESPS:40 HOURS:11,420 COSTS(000):$0 Bulk Gasoline Terminals -- NSPS Subpart XX FORMS: 0664.06 OMB NO: 2060-0012 EXPIRATION DATE: 08/31/2002 RESPS:5,028 HOURS:384,693 COSTS(000):$73 NSPS for VOC Equipment Leaks in the Synthetic Organic Chemical Industry (SOCMI) -- 40 CFR Part 60, Subpart VV FORMS: 0662.06 OMB NO: 2060-0015 EXPIRATION DATE: 08/31/2003 RESPS:22,846 HOURS:8,363 COSTS(000):$0 Environmental Radiation Ambient Monitoring System (ERAMS) FORMS: NONE OMB NO: 2060-0016 EXPIRATION DATE: 07/31/2002 RESPS:44 HOURS:1,760 COSTS(000):$14 Metallic Mineral Processing Plants, Standards of Performance for NSPS -- Subpart LL FORMS: 0982.06 OMB NO: 2060-0019 EXPIRATION DATE: 01/31/2001 RESPS:36 HOURS:1,516 COSTS(000):$3,268 New Source Performance Standards for Nitric Acid Plants -- Subpart G FORMS: 1056.06 OMB NO: 2060-0021 EXPIRATION DATE: 02/28/2003 RESPS:170 HOURS:9,959 COSTS(000):$2,828 New Source Performance Standard (NSPS) for Kraft Pulp Mills -- Subpart BB FORMS: 1055.06 OMB NO: 2060-0022 EXPIRATION DATE: 08/31/2002 RESPS:197 HOURS:19,045 COSTS(000):$123 Standard of Performance for Petroleum Refineries -- NSPS, Subpart J FORMS: 1054.07 OMB NO: 2060-0023 EXPIRATION DATE: 02/28/2003 RESPS:494 HOURS:28,606 COSTS(000):$3,095 Standard of Performance for Electric Utility Steam Generating Units -- NSPS Subpart Da FORMS: 1053.06 OMB NO: 2060-0025 EXPIRATION DATE: 09/30/2001 RESPS:28 HOURS:7,968 COSTS(000):$941 New Source Performance Standard for Portland Cement Plants -- Subpart F FORMS: 1051.07 OMB NO: 2060-0026 EXPIRATION DATE: 02/28/2003 RESPS:2,640 HOURS:62,865 COSTS(000):$9,900 Standards of Performance for Fossil-Fuel-Fired Steam Generating Units -- NSPS Subpart D FORMS: 1052.06 OMB NO: 2060-0028 EXPIRATION DATE: 01/31/2001 RESPS:1,500 HOURS:76,681 COSTS(000):$0 NSPS for Stationary Gas Turbines, Information Requirements -- Subpart GG FORMS: 1071.06 OMB NO: 2060-0029 EXPIRATION DATE: 09/30/2002 RESPS:13 HOURS:1,795 COSTS(000):$35 Standard of Performance for Primary and Secondary Emissions from Basic Oxygen Process Furnaces -- NSPS Subparts N and Na FORMS: 1069.06 OMB NO: 2060-0031 EXPIRATION DATE: 02/28/2001 RESPS:2,220 HOURS:4,365 COSTS(000):$0 New Source Performance Standards(NSPS) for Primary Aluminum Reduction Plants, Recordkeeping and Reporting FORMS: 1683.02 OMB NO: 2060-0032 EXPIRATION DATE: 01/31/2001 RESPS:365 HOURS:182 COSTS(000):$0 NSPS for Ammonium Sulfate Manufacturing Plants FORMS: 1066.02 OMB NO: 2060-0034 EXPIRATION DATE: 09/30/2003 RESPS:171 HOURS:145,599 COSTS(000):$7 NSPS Subpart MM-Automobile and Light Duty Truck Surface Coating Opeations 40 CFR Part 63, Subpart MM FORMS: 1064.09 OMB NO: 2060-0035 EXPIRATION DATE: 06/30/2001 RESPS:228 HOURS:9,089 COSTS(000):$4,690 NSPS for Sewage Sludge Treatment Plant Incineration, Reporting and Recordkeeping Requirements -- Subpart O FORMS: 1063.07 OMB NO: 2060-0037 EXPIRATION DATE: 06/30/2003 RESPS:11 HOURS:963 COSTS(000):$0 NSPS for Phosphate Fertilizer Industry, 40 CFR Part 60, Subparts T, U, V, W, and X FORMS: 1061.08 OMB NO: 2060-0038 EXPIRATION DATE: 06/30/2003 RESPS:182 HOURS:48,413 COSTS(000):$95 The New Source Performance Standards (NSPS) for Steel Plants: Electric Arc Furnaces and Argon-Oxygen Decarburization Vessels. FORMS: 1060.10 40CFR PART60 SUBPARTAA SUBPARTAAA OMB NO: 2060-0040 EXPIRATION DATE: 04/30/2001 RESPS:96 HOURS:8,544 COSTS(000):$255 Standards of Performance for Municipal Incinerators -- NSPS Subpart E FORMS: 1058.06 OMB NO: 2060-0041 EXPIRATION DATE: 08/31/2002 RESPS:212 HOURS:23,320 COSTS(000):$477 New Source Performance Standards, Sulfuric Acid Plants -- Subpart H FORMS: 1057.08 OMB NO: 2060-0043 EXPIRATION DATE: 08/31/2002 RESPS:43 HOURS:6,769 COSTS(000):$164 Inorganic Arsenic Emissions from Glass Manufacturing Plants FORMS: 1081.06 OMB NO: 2060-0048 EXPIRATION DATE: 01/31/2001 RESPS:388 HOURS:1,800 COSTS(000):$0 Emission Defect Information and Voluntary Emission Recall Reports FORMS: 282.10 OMB NO: 2060-0050 EXPIRATION DATE: 06/30/2003 RESPS:2,320 HOURS:31,746 COSTS(000):$0 NSPS 40 CFR, Part 60, Subpart OOO - Nonmetallic Mineral Pro- cessing FORMS: 1084.06 OMB NO: 2060-0054 EXPIRATION DATE: 10/31/2002 RESPS:61 HOURS:398 COSTS(000):$174 NSPS 40 CFR Part 60, Subpart CC, Glass Manufacturing Plants FORMS: ICR1131.06 OMB NO: 2060-0059 EXPIRATION DATE: 01/31/2003 RESPS:85 HOURS:2,696 COSTS(000):$228 Synthetic Fiber Production Facilities -- NSPS Subpart HHH FORMS: 1156.08 OMB NO: 2060-0060 EXPIRATION DATE: 01/31/2001 RESPS:2 HOURS:1,722 COSTS(000):$0 Emission Control System Performance Warranty Regulations and Voluntary Aftermarket Part Certification Program FORMS: 0116.05 OMB NO: 2060-0063 EXPIRATION DATE: 01/31/2003 RESPS:102 HOURS:4,190 COSTS(000):$95 Lime Manufacturing -- NSPS Subpart HH FORMS: 1167.06 OMB NO: 2060-0067 EXPIRATION DATE: 10/31/2002 RESPS:108 HOURS:6,137 COSTS(000):$0 Equipment Leaks of VOC in Petroleum Refineries -- NSPS Subpart GGG FORMS: 0983.06 OMB NO: 2060-0068 EXPIRATION DATE: 08/31/2001 RESPS:154 HOURS:98,921 COSTS(000):$0 NESHAP for Equipment Leaks (Fugitive Emission Sources) -- Subpart J FORMS: 1153.06 OMB NO: 2060-0071 EXPIRATION DATE: 09/30/2001 RESPS:176 HOURS:16,159 COSTS(000):$1,980 NESHAP for Vinyl Chloride, Information Requirements -- Subpart F FORMS: 0186.08 OMB NO: 2060-0072 EXPIRATION DATE: 02/28/2003 RESPS:3,016 HOURS:575,033 COSTS(000):$25,955 NSPS Subpart Db, Standards of Performance for Industrial-Commer- cial-Institutional Steam Generating Units FORMS: 1088.09 OMB NO: 2060-0073 EXPIRATION DATE: 06/30/2003 RESPS:21 HOURS:329 COSTS(000):$52 NSPS, 40 CFR Part 60, Subpart FFF for Flexible Vinyl and Urethane Coating and Printing FORMS: 1157.06 OMB NO: 2060-0074 EXPIRATION DATE: 02/28/2001 RESPS:22,183 HOURS:126,141 COSTS(000):$0 NSPS for Volatile Organic Liquid Storage Vessels -- Subpart Kb, 40 CFR Part 60 FORMS: 1132.05 OMB NO: 2060-0078 EXPIRATION DATE: 06/30/2003 RESPS:3,750 HOURS:1,649 COSTS(000):$0 Mobile Source Emission Factor Recruitment Questionnaire FORMS: 0619.08 OMB NO: 2060-0079 EXPIRATION DATE: 01/31/2003 RESPS:93 HOURS:1,483 COSTS(000):$0 Petroleum Dry Cleaners -- NSPS Subpart JJ FORMS: 0997.06 OMB NO: 2060-0080 EXPIRATION DATE: 06/30/2003 RESPS:23 HOURS:35 COSTS(000):$0 NSPS CFR 40, Part 60, Subpart L - Secondary Lead Smelters FORMS: 112.06 OMB NO: 2060-0081 EXPIRATION DATE: 06/30/2003 RESPS:82 HOURS:123 COSTS(000):$18 NSPS Subpart KK - Lead-Acid Battery Manufacturing, 40 CFR Part 60 Subpart KK FORMS: 1072.06 OMB NO: 2060-0082 EXPIRATION DATE: 01/31/2003 RESPS:121 HOURS:250 COSTS(000):$0 Information Requirements for Grain Elevators -- NSPS Subpart DD FORMS: 1130.06 OMB NO: 2060-0083 EXPIRATION DATE: 01/31/2003 RESPS:200 HOURS:6,890 COSTS(000):$0 Hot Mix Asphalt Facilities -- NSPS Subpart I FORMS: 1127.06 OMB NO: 2060-0084 EXPIRATION DATE: 09/30/2002 RESPS:520 HOURS:2,404,606 COSTS(000):$73,642 Ambient Air Quality Surveillance -- 40 CFR Part 58 FORMS: 0940.16 OMB NO: 2060-0086 EXPIRATION DATE: 01/31/2001 RESPS:17,100 HOURS:2,575 COSTS(000):$0 Investigations into Possible Noncompliance of Motor Vehicles with Federal Emission Standards FORMS: 0222.04 OMB NO: 2060-0088 EXPIRATION DATE: 01/31/2001 RESPS:54 HOURS:11,448 COSTS(000):$29 Annual Updates of Emission Data to the Aerometic Information Retrieval System (AIRS) FORMS: 0916.08 OMB NO: 2060-0092 EXPIRATION DATE: 09/30/2001 RESPS:143 HOURS:2,232 COSTS(000):$3 National Emission Standards for Hazardous Air Pollutants, Beryllium; Information Requirements -- Subpart C FORMS: 0193.06 OMB NO: 2060-0094 EXPIRATION DATE: 05/31/2002 RESPS:75 HOURS:150 COSTS(000):$0 Verification of Test Parameters and Parts Lists for Light-Duty Vehicles and Light-Duty Trucks FORMS: 0167.06 OMB NO: 2060-0095 EXPIRATION DATE: 01/31/2001 RESPS:12,315 HOURS:9,705 COSTS(000):$862 Importation Requirements for Importation of Nonconforming Vehicles FORMS: 10.08 OMB NO: 2060-0096 EXPIRATION DATE: 12/31/2001 RESPS:212 HOURS:35,884 COSTS(000):$0 Source Compliance and State Action Reporting -- 40 CFR Part 51, Subpart Q FORMS: SF-83 0107.06 OMB NO: 2060-0097 EXPIRATION DATE: 06/30/2003 RESPS:24 HOURS:26,504 COSTS(000):$0 National Emission Standard for Mercury -- NESHAP Part 61 Subpart E FORMS: 0113.07 OMB NO: 2060-0101 EXPIRATION DATE: 02/28/2003 RESPS:134,384 HOURS:362,159 COSTS(000):$0 National Emission Standard for Asbestos -- NESHAP Subpart M FORMS: 0111.09 OMB NO: 2060-0104 EXPIRATION DATE: 12/31/2001 RESPS:70 HOURS:968,176 COSTS(000):$12,700 Motor Vehicle Emission Certification and Fuel Economy Compliance, FORMS: EPA-ICR-1872.01 EPA-ICR-0783.38 OMB NO: 2060-0105 EXPIRATION DATE: 08/31/2001 RESPS:50 HOURS:2,988 COSTS(000):$0 New Source Performance Standards for Graphic Arts Industry FORMS: 0657.06 OMB NO: 2060-0106 EXPIRATION DATE: 01/31/2003 RESPS:1,600 HOURS:101,070 COSTS(000):$1,120 NSPS for Metal Furniture Coating -- 40 CFR Part 60, Subpart EE FORMS: 0649.07 OMB NO: 2060-0107 EXPIRATION DATE: 01/31/2003 RESPS:585 HOURS:15,335 COSTS(000):$398 NSPS for Metal Coil Surface Coating -- 40 CFR Part 60, Subpart TT Coating FORMS: 0660.07 OMB NO: 2060-0108 EXPIRATION DATE: 01/31/2003 RESPS:1,273 HOURS:29,564 COSTS(000):$618 NSPS for Large Appliance Surface Coating -- 40 CFR Part 60, Subpart SS FORMS: 0659.07 OMB NO: 2060-0110 EXPIRATION DATE: 01/31/2001 RESPS:5 HOURS:7.5 COSTS(000):$0 New Source Performance Standards (NSPS) for Secondary Brass and Brass and Bronze Production Plants, Recordkeeping and Reporting FORMS: 1604.05 OMB NO: 2060-0111 EXPIRATION DATE: 08/31/2001 RESPS:35 HOURS:2,445 COSTS(000):$256 NSPS Subpart NN Phosphate Rock FORMS: 1078.05 OMB NO: 2060-0114 EXPIRATION DATE: 07/31/2003 RESPS:128 HOURS:19,098 COSTS(000):$689 NSPS - Wool Fiberglas Insulation Manufacturing Plants, 40 CFR Part 60, Subpart PPP. NESHAP-MACT - Wool Fiberglass Manufactur- ing Plants, 40 CFR Part 63, Subpart NNN FORMS: 1160.06 OMB NO: 2060-0120 EXPIRATION DATE: 01/31/2001 RESPS:1,298 HOURS:181,462 COSTS(000):$140 Standards of Performance for Onshore Natural Gas Processing Plants FORMS: 1086.05 OMB NO: 2060-0121 EXPIRATION DATE: 06/30/2001 RESPS:183 HOURS:20,954 COSTS(000):$0 Standards of Performance for Storage Vessels of Petroleum Liquids, Construction, Reconstruction of Modification Commenced After May 18, 1978, and Prior to July 23, 1984 -- NSPS Subpart Ka FORMS: 1050.06 OMB NO: 2060-0122 EXPIRATION DATE: 09/30/2001 RESPS:399 HOURS:18,729 COSTS(000):$14 Standards of Performance for Coal Preparation Plants -- NSPS Subpart Y FORMS: 1062.06 OMB NO: 2060-0124 EXPIRATION DATE: 05/31/2002 RESPS:60 HOURS:90 COSTS(000):$0 Motor Vehicle Exclusion Determination -- 40 CFR 85.1703 FORMS: 0012.11 OMB NO: 2060-0135 EXPIRATION DATE: 05/31/2002 RESPS:17,020 HOURS:65,788 COSTS(000):$756 Enforcement Policy Regarding the Sale and Use of Aftermarket Catalytic Converters FORMS: 1292.05 OMB NO: 2060-0145 EXPIRATION DATE: 09/30/2002 RESPS:250 HOURS:14,691 COSTS(000):$765 Standards of Performance for Volatile Organic Compound Emissions from the Polymer Manufacturing Industry -- NSPS Subpart DDD FORMS: 1150.05 OMB NO: 2060-0150 EXPIRATION DATE: 01/31/2001 RESPS:10,300 HOURS:20,900 COSTS(000):$31 Registration of Fuels and Fuel Additives: Requirements for Manufacturers FORMS: 309.09 OMB NO: 2060-0156 EXPIRATION DATE: 09/30/2001 RESPS:257 HOURS:18,651 COSTS(000):$485 Standard of Performance for New Stationary Sources: Rubber Tire Manufacturing -- Subpart BBB FORMS: 1158.06 OMB NO: 2060-0161 EXPIRATION DATE: 01/31/2001 RESPS:3,093 HOURS:7,653 COSTS(000):$1,348 New Source Performance Standards for New Residential Wood Heaters -- 40 CFR 60.530 thru 60.539(b), Subpart AAA FORMS: 1176.05 OMB NO: 2060-0162 EXPIRATION DATE: 07/31/2003 RESPS:121 HOURS:3,639 COSTS(000):$0 New Source Performance Standards (NSPS), 40 CFR Part 60, Subpart TTT, Surface Coating of Plastic Parts for Business Machines FORMS: 1093.06 OMB NO: 2060-0170 EXPIRATION DATE: 01/31/2001 RESPS:1,213 HOURS:6,492 COSTS(000):$3 Recordkeeping and Periodic Reporting of the Production, Import, of Ozone-Depleting Substances FORMS: 7600-5 1432.17 OMB NO: 2060-0171 EXPIRATION DATE: 01/31/2001 RESPS:58 HOURS:3,982 COSTS(000):$101,220 New Source Performance Standards for Magnetic Tape Coating Facilities -- Subpart SSS FORMS: 1135.06 OMB NO: 2060-0172 EXPIRATION DATE: 01/31/2001 RESPS:322 HOURS:36,866 COSTS(000):$57 NSPS for Petroleum Refinery Wastewater Systems Reporting and Recordkeeping -- Subpart QQQ FORMS: 1136.05 OMB NO: 2060-0178 EXPIRATION DATE: 12/31/2001 RESPS:2,706,000 HOURS:1,319 COSTS(000):$0 Regulation of Fuel and Fuel Additives, Gasoline Volatility Rule FORMS: 1367.05 OMB NO: 2060-0181 EXPIRATION DATE: 12/31/2001 RESPS:181 HOURS:14,376 COSTS(000):$270 Standard of Performance for New Stationary Sources, Polymeric Coating of Supporting Substrates -- Subpart VVV FORMS: 1284.05 OMB NO: 2060-0182 EXPIRATION DATE: 05/31/2002 RESPS:324 HOURS:14,685 COSTS(000):$0 NESHAP Benzene Emissions from Bulk Transfer Operations FORMS: 1154.05 OMB NO: 2060-0183 EXPIRATION DATE: 02/28/2003 RESPS:240 HOURS:17,028 COSTS(000):$0 Benzene Waste Operations -- NESHAP Subpart FF FORMS: 1541.06 OMB NO: 2060-0185 EXPIRATION DATE: 01/31/2001 RESPS:728 HOURS:8,628 COSTS(000):$0 National Emission Standards for Hazardous Air Pollutants Benzene Emissions from Benzene Storage Vessels, and Coke By-Product Recovery Plants FORMS: 1080.09 OMB NO: 2060-0191 EXPIRATION DATE: 06/30/2002 RESPS:87 HOURS:45,748 COSTS(000):$1,737 National Emission Standards for Hazardous Air Pollutants: Radionuclides -- 40 CFR Part 61, Subparts B, H, K, R, and W FORMS: 1100.09 OMB NO: 2060-0197 EXPIRATION DATE: 01/31/2003 RESPS:5,534 HOURS:278,687 COSTS(000):$16,386 Standards of Performance of Volatile Organic Compound (VOC) Emissions for the Synthetic Organic Chemical Manufacturing Industry (SOCMI), Air Oxidation Unit Processes, Subpart III; ... FORMS: 0998.06 OMB NO: 2060-0202 EXPIRATION DATE: 01/31/2001 RESPS:1,276 HOURS:229,673 COSTS(000):$9,940 Small Industrial-Commerical-Institutional Steam Generating Units -- NSPS for Subpart DC FORMS: 1564.04 OMB NO: 2060-0210 EXPIRATION DATE: 03/31/2002 RESPS:212 HOURS:70,730 COSTS(000):$563 NSPS Municipal Waste Combustors (MWC) for Subpart Ea and Subpart Eb FORMS: 1506.08 OMB NO: 2060-0220 EXPIRATION DATE: 09/30/2002 RESPS:299 HOURS:3,379 COSTS(000):$80 New Source Performance Standards for Municipal Solid Waste Landfills -- 40 CFR Part 60, Subpart WWW FORMS: 1557.04 OMB NO: 2060-0226 EXPIRATION DATE: 01/31/2001 RESPS:340 HOURS:11,515 COSTS(000):$735 Significant New Alternatives Policy (SNAP) Program under Title VI of the Clean Air Act Amendments of 1990 (Final Rule) FORMS: 1265-93 1265-94 1265-93(1) 1596.04 OMB NO: 2060-0234 EXPIRATION DATE: 09/30/2003 RESPS:5,270 HOURS:1,212,129 COSTS(000):$0 NESHAP for Perchloroethylene (PCE) Dry Cleaning Facilities, 40 CFR Part 63.324, Subpart M FORMS: 1415.04 OMB NO: 2060-0239 EXPIRATION DATE: 04/30/2002 RESPS:602 HOURS:76,925 COSTS(000):$0 Maximum Achievable Control Technology Standards Development under Title III (Section 112) of the Clean Air Act Regulatory Development Program FORMS: 1602.03 OMB NO: 2060-0243 EXPIRATION DATE: 01/31/2001 RESPS:25,659 HOURS:5,281,333 COSTS(000):$0 Part 70 Operating Permits Regulations FORMS: 1587.04 OMB NO: 2060-0247 EXPIRATION DATE: 05/31/2002 RESPS:70,037 HOURS:8,882 COSTS(000):$0 Stratospheric Ozone Protection, Servicing of Motor Vehicle Air Conditioners -- 40 CFR Subpart B (82.30 et seq.) FORMS: 1617.03 OMB NO: 2060-0249 EXPIRATION DATE: 03/31/2002 RESPS:119 HOURS:44,642 COSTS(000):$219 Air Pollution Regulations for Outer Continental Shelf Activities: FORMS: 1601.04 OMB NO: 2060-0251 EXPIRATION DATE: 08/31/2002 RESPS:310 HOURS:6,019 COSTS(000):$121 NSPS for Calciners and Dryers in Mineral Industries -- Subpart UUU FORMS: 0746.04 OMB NO: 2060-0253 EXPIRATION DATE: 01/31/2001 RESPS:600 HOURS:10,740 COSTS(000):$2,365 National Emission Standards for Coke Oven Batteries, 40 CFR Part 63, Subpart L FORMS: 1362.03 OMB NO: 2060-0256 EXPIRATION DATE: 07/31/2003 RESPS:2,342,047 HOURS:419,546 COSTS(000):$0 National Recycling and Emissions Reduction Program FORMS: 1626.07 OMB NO: 2060-0258 EXPIRATION DATE: 09/30/2002 RESPS:10,085 HOURS:1,330,327 COSTS(000):$135,632 Information Collection Request for the Acid Rain Program under Title IV of the Clean Air Act Amendments of 1990 FORMS: 1633.12 OMB NO: 2060-0264 EXPIRATION DATE: 01/31/2001 RESPS:4,687 HOURS:79,885 COSTS(000):$0 Amended Application Requirements for the Approval and Delegation of Federal Air Toxics Programs to State and Local Agencies FORMS: 1643.03 OMB NO: 2060-0266 EXPIRATION DATE: 11/30/2001 RESPS:149 HOURS:19,743 COSTS(000):$0 Control Technology Determination for Equivalent Emissions Limitations by Permit FORMS: 1648.02 OMB NO: 2060-0268 EXPIRATION DATE: 09/30/2001 RESPS:1 HOURS:6 COSTS(000):$0 National Emission Standards for Hazardous Air Pollutants for Industrial Process Cooling Towers FORMS: EPA-1876.01 OMB NO: 2060-0269 EXPIRATION DATE: 06/30/2003 RESPS:652 HOURS:30,842 COSTS(000):$1,147 Standards of Performance of Volatile Organic Compound (VOC) Emissions from the Synthetic Organic Chemical Manufacturing Industry (SOCMI), Reactor Processes, Subpart RRR FORMS: 1178.05 OMB NO: 2060-0273 EXPIRATION DATE: 05/31/2001 RESPS:4,830 HOURS:45,207 COSTS(000):$4,091 NESHAP for Halogenated Solvent Cleaners/Halogenated Hazardous Air Pollutants (HAP) FORMS: 1652.03 OMB NO: 2060-0275 EXPIRATION DATE: 01/31/2001 RESPS:153,679 HOURS:17,992 COSTS(000):$3,741,614 Gasoline Detergents Certification Program (Final Rule) FORMS: 1655.03 OMB NO: 2060-0277 EXPIRATION DATE: 01/31/2001 RESPS:86,940 HOURS:41,264 COSTS(000):$2,146 Modifications to Standards and Requirements for Reformulated FORMS: 1591.10 OMB NO: 2060-0279 EXPIRATION DATE: 09/30/2001 RESPS:280 HOURS:13,600 COSTS(000):$0 General Conformity of Federal Actions to State Implementation Plans -- Part 51, Subpart W and Part 93, Subpart B FORMS: 1637.04 OMB NO: 2060-0282 EXPIRATION DATE: 02/28/2001 RESPS:308 HOURS:1,727,724 COSTS(000):$98,460 Hazardous Organic NESHAP (HON) -- NESHAP Subparts F, G, H, and I FORMS: 1414.03 OMB NO: 2060-0283 EXPIRATION DATE: 01/31/2001 RESPS:98 HOURS:7,328 COSTS(000):$228 NESHAP Subpart O: National Emission Standards for Hazardous Air Pollutants (NESHAP) for Commerical Ethylene Oxide Sterilization and Fumigation Operations FORMS: 1666.03 OMB NO: 2060-0287 EXPIRATION DATE: 02/28/2001 RESPS:441 HOURS:78,006 COSTS(000):$0 Compression Ignition Non-Road Engine Certification Application FORMS: 1684.04 OMB NO: 2060-0289 EXPIRATION DATE: 02/28/2002 RESPS:105 HOURS:28,131 COSTS(000):$0 Federal Standards for Marine Tank Vessel Loading Operations and National Emission Standards for Hazardous Air Pollutants for Marine Tank Vessel Loading Operations -- 40 CFR Part 63 Subpart Y FORMS: 1679.03 OMB NO: 2060-0290 EXPIRATION DATE: 09/30/2001 RESPS:29 HOURS:4,525 COSTS(000):$9 National Emission Standards for Hazardous Air Pollutants for Epoxy Resin Production and Non-Nylon Polyamide Production -- Subpart W FORMS: 16981.03 OMB NO: 2060-0294 EXPIRATION DATE: 01/31/2001 RESPS:12,315 HOURS:25,100 COSTS(000):$1,255 Reporting and Recordkeeping Requirements for Importation of FORMS: 1673.02 OMB NO: 2060-0296 EXPIRATION DATE: 09/30/2001 RESPS:48 HOURS:16,033 COSTS(000):$150 Secondary Lead Smelter Industry, Information Requirements -- MACT Subpart X FORMS: 1686.03 OMB NO: 2060-0297 EXPIRATION DATE: 05/31/2003 RESPS:3 HOURS:67,467 COSTS(000):$6,500 Registration of Fuels and Fuel Additives: Health-Effects Research Requirements for Manufacturers -- 40 CFR 79, Subpart F FORMS: 1696.03 OMB NO: 2060-0302 EXPIRATION DATE: 09/30/2001 RESPS:338 HOURS:2,996 COSTS(000):$170 Retrofit/Rebuild Requirements for 1993 and Earlier Model Year Urban Buses FORMS: 1702.02 OMB NO: 2060-0306 EXPIRATION DATE: 05/31/2001 RESPS:12 HOURS:480 COSTS(000):$0 Clean Air Act Tribal Authority FORMS: 1676.02 OMB NO: 2060-0308 EXPIRATION DATE: 07/31/2001 RESPS:12,843 HOURS:87 COSTS(000):$0 Regulation of Fuel and Fuel Additives, Fuel Quality Regulations for Highway Diesel Fuel Sold in 1993 and Later Calendar Years FORMS: 1718.02 OMB NO: 2060-0313 EXPIRATION DATE: 01/31/2001 RESPS:1,000 HOURS:208,133 COSTS(000):$0 Natioanal Emission Standards for Hazardous Air Pollutants (NESHAP) for Off-Site Waste and Recovery Operations (Supart DD) FORMS: 1717.02 OMB NO: 2060-0314 EXPIRATION DATE: 01/31/2001 RESPS:2,870 HOURS:829,500 COSTS(000):$0 National Emission Standards for Hazardous Air Pollutants for Aerospace Manufacturing and Rework Operations FORMS: 1687.03 OMB NO: 2060-0318 EXPIRATION DATE: 02/28/2001 RESPS:6,228 HOURS:557,248 COSTS(000):$0 Standards of Performance for Air Emission Standards for Tanks, CC, and 40 CFR Part 265, Subpart CC FORMS: 1593.04 OMB NO: 2060-0320 EXPIRATION DATE: 09/30/2001 RESPS:3,100 HOURS:1,550 COSTS(000):$0 Reporting and Recordkeeping Requirements for the Importation of Nonconforming Marine Engines FORMS: 1723.02 OMB NO: 2060-0321 EXPIRATION DATE: 01/31/2001 RESPS:67 HOURS:51,099 COSTS(000):$0 Control of Air Pollution, Emission Standards for New Gasoline Spark-Ignition Marine Engines FORMS: 1722.02 OMB NO: 2060-0322 EXPIRATION DATE: 01/31/2001 RESPS:14 HOURS:12,210 COSTS(000):$0 Marine Engine Manufacturer In-Use Emission Testing Program FORMS: 1726.02 OMB NO: 2060-0323 EXPIRATION DATE: 01/31/2001 RESPS:40 HOURS:34,770 COSTS(000):$0 Marine Engine Manufacturers Production Line Testing Reporting and Recordkeeping Requirements FORMS: 1725.02 OMB NO: 2060-0324 EXPIRATION DATE: 02/28/2001 RESPS:54,721 HOURS:91,430 COSTS(000):$34 40 CFR Part 63, Subpart JJ, Final Standards for Hazardous Air Pollutants From Wood Furniture Manufacturing Operations FORMS: 1716.02 OMB NO: 2060-0325 EXPIRATION DATE: 02/28/2001 RESPS:526 HOURS:32,575 COSTS(000):$850 National Emission Standards for Hazardous Air Pollutants for Source Categories: Gasoline Distribution (Stage I) -- 40 CFR Part 63, Subpart R FORMS: 1659.03 OMB NO: 2060-0326 EXPIRATION DATE: 01/31/2001 RESPS:13 HOURS:7,042 COSTS(000):$89 National Emission Standards for Magnetic Tape Manufacturing Operations -- Subpart EE FORMS: 1678.03 OMB NO: 2060-0327 EXPIRATION DATE: 01/31/2001 RESPS:1,896 HOURS:516,186 COSTS(000):$75,300 National Emission Standards for Hazardous Air Pollutants (NESHAP) for Chromium Emissions from Hard and Decorative Chromium Electro- plating and Chromium Anodizing Tanks FORMS: 1611.03 OMB NO: 2060-0328 EXPIRATION DATE: 09/30/2001 RESPS:94 HOURS:3,692 COSTS(000):$0 Reporting and Recordkeeping Requirements under EPA's Natural Gas STAR Program FORMS: SF-1736.02 OMB NO: 2060-0329 EXPIRATION DATE: 08/31/2001 RESPS:161 HOURS:375 COSTS(000):$1 Reporting and Recordkeeping Requirements under EPA's AgSTAR Program FORMS: 1735.02 OMB NO: 2060-0330 EXPIRATION DATE: 08/31/2003 RESPS:45 HOURS:22,149 COSTS(000):$0 National Emissions Standards for Hazardous Air Pollutants for Shipbuilding and Ship Repair Facilities (Surface Coating) CFR 40 Part 63, Subpart Ii FORMS: 1712.03 OMB NO: 2060-0335 EXPIRATION DATE: 09/30/2003 RESPS:273 HOURS:52,495 COSTS(000):$403 MACT Subpart KK, National Emission Standards for the Printing and Publishing Industry FORMS: 1739.03 OMB NO: 2060-0336 EXPIRATION DATE: 01/31/2001 RESPS:2,059 HOURS:677,719 COSTS(000):$19,813 Federal Operations Permits Program of the Clean Air Act -- Part 71 FORMS: 1713.03 OMB NO: 2060-0337 EXPIRATION DATE: 09/30/2001 RESPS:53 HOURS:4,240 COSTS(000):$0 State Small Business Stationary Source Technical and Environmental Compliance Assistance Program Annual Reporting Form FORMS: 1748.02 OMB NO: 2060-0338 EXPIRATION DATE: 02/28/2001 RESPS:362 HOURS:53,985 COSTS(000):$1,308 Non-Road Spark-Ignition Engines At or Below 19 Kilowatts for Emission Certification and the Averaging, Banking, and Trading Program FORMS: 1695.06 OMB NO: 2060-0340 EXPIRATION DATE: 08/31/2001 RESPS:330 HOURS:493,000 COSTS(000):$570 National Emissions Standards for Hazardous Air Pollutants for Petroleum Refineries -- 40 CFR Part 63, Subpart CC FORMS: 1692.03 OMB NO: 2060-0345 EXPIRATION DATE: 01/31/2001 RESPS:30 HOURS:6,032.5 COSTS(000):$0 Regulations for a Voluntary Emissions Standards Program Applicable to Manufactures of Light-Duty Vehicles and Trucks Beginning in Model Year 1977 FORMS: 1761.02 OMB NO: 2060-0347 EXPIRATION DATE: 04/30/2003 RESPS:15,529 HOURS:217,714 COSTS(000):$15 Information Collection Activities Associated with EPA's Energy Star Buildings Program FORMS: ICR1772.02 OMB NO: 2060-0348 EXPIRATION DATE: 06/30/2003 RESPS:375 HOURS:29,695 COSTS(000):$0 Reporting and Recordkeeping Requirements for National Volatile Organic Compound Emission Standards for Consumer products CFR 40 Part 59, Subpart C FORMS: 1764.02 OMB NO: 2060-0350 EXPIRATION DATE: 09/30/2003 RESPS:5,000,000 HOURS:416,667 COSTS(000):$500 Mobile Air Conditioner Retrofitting Program, 40 CFR Part 82.180 FORMS: 1774.02 OMB NO: 2060-0353 EXPIRATION DATE: 06/30/2003 RESPS:10 HOURS:22 COSTS(000):$0 Reporting and Recordkeeping Requirements for National Volatile Organic Compound Emission Standards for Automobile Refinish Coatings CFR 40 Part 59 Subpart B FORMS: 1765.02 OMB NO: 2060-0357 EXPIRATION DATE: 01/31/2001 RESPS:214 HOURS:17,796 COSTS(000):$0 National Emisssion Standards for Hazardous Air Pollutants for FORMS: 1783.01 OMB NO: 2060-0358 EXPIRATION DATE: 01/31/2001 RESPS:505 HOURS:350,502 COSTS(000):$47 National Emission Standards for Hazardous Air Pollutants for FORMS: 1781.01 OMB NO: 2060-0361 EXPIRATION DATE: 01/31/2001 RESPS:30 HOURS:3,790 COSTS(000):$66 National Emission Standards for Hazardous Air Pollutants for Phosphoric Acid Manufacturing and Phosphate Fertilizers Production FORMS: 1790.01 OMB NO: 2060-0362 EXPIRATION DATE: 01/31/2001 RESPS:40 HOURS:6,107 COSTS(000):$21 Recordkeeping and Reporting Requirements for the Mineral Wool FORMS: 1799.01 OMB NO: 2060-0363 EXPIRATION DATE: 09/30/2001 RESPS:28 HOURS:28,211 COSTS(000):$274 Standards of Performance for New Stationary Sources: Hospital/ Medical/Infectious Waste Incinerators FORMS: 1730.02 OMB NO: 2060-0369 EXPIRATION DATE: 04/30/2001 RESPS:233 HOURS:1 COSTS(000):$0 Information Collection for Equipment Manufacturer Flexibility FORMS: 1826.01 OMB NO: 2060-0370 EXPIRATION DATE: 01/31/2001 RESPS:390 HOURS:89,173 COSTS(000):$369 National Emission Standards for Hazardous Air Pollutants for FORMS: 1807.01 OMB NO: 2060-0373 EXPIRATION DATE: 02/28/2001 RESPS:600 HOURS:163,352 COSTS(000):$0 ICR for Regulations Governing Constructed or Reconstructed Major Sources FORMS: 1658.02 OMB NO: 2060-0376 EXPIRATION DATE: 09/30/2001 RESPS:3,000 HOURS:147,560 COSTS(000):$1,230 Compliance Assurance Monitoring (CAM) Rule FORMS: 1663.02 OMB NO: 2060-0377 EXPIRATION DATE: 01/31/2001 RESPS:1 HOURS:1 COSTS(000):$2 National Emission Standards for Hazardous Air Pollutants for Chemical Recovery Combustion Sources at Kraft, Soda, Sulfite, and Stand-Alone Semichemical Pulp Mills (Proposed Rule) FORMS: 1805.01 OMB NO: 2060-0382 EXPIRATION DATE: 06/30/2001 RESPS:30 HOURS:17,126 COSTS(000):$539 Reporting and Recordkeeping Requirements under the Perfluorocompound (PFC) Emission Reduction Partnership for the Semiconductor Industry FORMS: 1823.01 OMB NO: 2060-0387 EXPIRATION DATE: 09/30/2001 RESPS:493 HOURS:53,924 COSTS(000):$1,337 Recordkeeping and Reporting Requirements for NESHAP for Total HAP Emissions from the Pulp and Paper Production Sources Category, Process Operations FORMS: 1657.03 OMB NO: 2060-0389 EXPIRATION DATE: 10/31/2001 RESPS:513 HOURS:5,257 COSTS(000):$100 Promulgation of Federal Implementation Plan for Arizona-Phoenix Moderate Area PM-10 (Includes a Proposed Rule for Vacant Lots, Unpaved Parking Lots, and Unpaved Roads for the Phoenix Area) FORMS: 1855.02 OMB NO: 2060-0390 EXPIRATION DATE: 12/31/2001 RESPS:112 HOURS:59,366 COSTS(000):$2,059 Federal Plan Recordkeeping and Reporting Requirements for Large Municipal Waste Combustors Constructed On or Before September 20, 1994 -- Subpart FFF FORMS: 1847.01 OMB NO: 2060-0391 EXPIRATION DATE: 09/30/2001 RESPS:31 HOURS:1,684 COSTS(000):$0 NESHAP for Ferroalloys Production FORMS: EPA-ICR-1831.01 OMB NO: 2060-0392 EXPIRATION DATE: 09/30/2001 RESPS:126 HOURS:54,384 COSTS(000):$3,600 Information Requirements for Locomotives and Locomotive Engines FORMS: EPAICR1800.01 OMB NO: 2060-0393 EXPIRATION DATE: 01/31/2002 RESPS:1,362 HOURS:65,851 COSTS(000):$0 National Volatile Organic Compound Emission Standards for Architectural Coatings FORMS: 1750.02 OMB NO: 2060-0394 EXPIRATION DATE: 10/31/2001 RESPS:1 HOURS:8 COSTS(000):$0 National Emission Standards for Hazardous Air Pollutants for Beryllium Rocket Motor Fuel Firing -- 40 CFR Part 63, Subpart D FORMS: 1125.02 OMB NO: 2060-0395 EXPIRATION DATE: 05/31/2002 RESPS:10 HOURS:16 COSTS(000):$0 Exclusion Determinations for New Non-Road Spark-Ignited Engines At or Below 19 Kilowatts, New Compression-Ignited Engines At or Above 37 Kilowatts, New Marine Engines, and New On-Road Heavy.... FORMS: 1852.01 OMB NO: 2060-0404 EXPIRATION DATE: 07/31/2002 RESPS:397 HOURS:53,168 COSTS(000):$1,606 Non-Road Compression-Ignition Engine At or Above 50 Kilowatts and On-Road Heavy-Duty Engine Application for Emission Certification and Participation in the Averaging, Banking, and Trading Program FORMS: 1851.01 OMB NO: 2060-0411 EXPIRATION DATE: 07/31/2002 RESPS:12 HOURS:1,866 COSTS(000):$18 Reporting Requirements under EPA's Voluntary Aluminum Industrial Partnership FORMS: 1867.01 OMB NO: 2060-0414 EXPIRATION DATE: 07/31/2002 RESPS:6 HOURS:2,002 COSTS(000):$40 National Emission Standards for Hazardous Air Pollutants for Primary Lead Smelters FORMS: 1856.02 OMB NO: 2060-0415 EXPIRATION DATE: 07/31/2002 RESPS:158 HOURS:36,319 COSTS(000):$253 National Emission Standards for Hazardous Air Pollutants for Polyether Polyois Production FORMS: 1811.02 OMB NO: 2060-0416 EXPIRATION DATE: 08/31/2002 RESPS:954 HOURS:77,331 COSTS(000):$1,432 National Emission Standards for Hazardous Air Pollutants for Portland Cement Manufacturing FORMS: 1801.02 OMB NO: 2060-0417 EXPIRATION DATE: 07/31/2002 RESPS:3,328 HOURS:27,298 COSTS(000):$355 NESHAP for Source Category: Oil and Natural Gas Production FORMS: 1788.02 OMB NO: 2060-0418 EXPIRATION DATE: 07/31/2002 RESPS:23 HOURS:213 COSTS(000):$2 NESHAP for Source Category: Natural Gas Transmission and Storage FORMS: 1789.02 OMB NO: 2060-0419 EXPIRATION DATE: 07/31/2002 RESPS:23 HOURS:23,190 COSTS(000):$15 National Emission Standards for Hazardous Air Pollutants for Steel Pickling, HCI Process Facilities and Hydrochloric Acid Regeneration Plants FORMS: 1821.02 OMB NO: 2060-0420 EXPIRATION DATE: 09/30/2002 RESPS:89 HOURS:6,125 COSTS(000):$1 Recordkeeping and Reporting Requirements for Source Categories: Generic Maximum Achievable Control Technology (MACT) National Emission Standards for Hazardous Air Pollutants (NESHAP) FORMS: 1871.02 OMB NO: 2060-0421 EXPIRATION DATE: 09/30/2002 RESPS:51 HOURS:11,500 COSTS(000):$0 Final Regional Haze Rule FORMS: 1813.02 OMB NO: 2060-0422 EXPIRATION DATE: 01/31/2003 RESPS:1,146 HOURS:133,404 COSTS(000):$0 Reporting and Recordkeeping Requirements for the Emission Guidelines for Hospital/Medical/Infectious Waste Incinerators FORMS: 1899.01 OMB NO: 2060-0423 EXPIRATION DATE: 02/28/2003 RESPS:6 HOURS:8,559 COSTS(000):$219 Reporting and Recordkeeping Requirements for the New Source Performance Standards for Small Municipal Waste Combustors -- Subpart AAAA FORMS: 1900.01 OMB NO: 2060-0424 EXPIRATION DATE: 02/28/2003 RESPS:90 HOURS:1,297 COSTS(000):$0 Emission Guidelines Reporting and Recordkeeping Requirements for Existing Small Municipal Waste Combustion (MWC) Units FORMS: 1901.01 OMB NO: 2060-0427 EXPIRATION DATE: 10/31/2003 RESPS:200 HOURS:80,383 COSTS(000):$0 Small Spark Ignition Manufacturers Production Line Testing FORMS: 1845.02 OMB NO: 2060-0428 EXPIRATION DATE: 02/28/2003 RESPS:41 HOURS:41 COSTS(000):$0 NESHAP for Source Category: Publicly Owned Treatment Works FORMS: 1891.02 OMB NO: 2060-0430 EXPIRATION DATE: 02/28/2003 RESPS:384 HOURS:15,110 COSTS(000):$890 Federal Emission Guidelines for Existing Municipal Solid Waste Landfills FORMS: 1893.02 OMB NO: 2060-0433 EXPIRATION DATE: 07/31/2003 RESPS:2,315 HOURS:148,031 COSTS(000):$687 Recordkeeping and Reporting Requirements for the Secondary Aluminum Production - NESHAP FORMS: 1894.02 OMB NO: 2060-0436 EXPIRATION DATE: 09/30/2003 RESPS:3,112 HOURS:5,602 COSTS(000):$38 Indoor Air Quality Practices in Large Buildings Survey FORMS: 1917.01 OMB NO: 2060-0442 EXPIRATION DATE: 01/31/2001 RESPS:10 HOURS:678 COSTS(000):$0 NSPS for Petroleum Storage Liquid Vessels -- 40 CFR 60, Supbart K FORMS: 1797.01 OMB NO: 2060-0445 EXPIRATION DATE: 10/31/2003 RESPS:3,982 HOURS:284,746 COSTS(000):$15,686 Emission Reporting Requirements for Ozone SIP Revisions (or Associated Federal Implementation Plans) Relating to Statewide Budgets for NOx Emissions to Reduce the Regional Transport of OZ. FORMS: 1857.02 Office of Prevention, Pesticides and Toxic Substances OMB NO: 2070-0003 EXPIRATION DATE: 03/31/2001 RESPS:150,000 HOURS:32,936 COSTS(000):$0 Polychlorinated Biphenyls (PCBs) Used in Electrical Equipment FORMS: 1000.06 OMB NO: 2070-0004 EXPIRATION DATE: 10/31/2002 RESPS:859 HOURS:4,542 COSTS(000):$0 Health and Safety Data Reporting: Submission of Lists and Copies of Health and Safety Studies FORMS: 0575.08 OMB NO: 2070-0008 EXPIRATION DATE: 02/28/2001 RESPS:176 HOURS:1,030 COSTS(000):$0 Polychlorinated Biphenyls (PCBs); Exclusions, Exemptions, and Use Authorizations FORMS: 1001.06 OMB NO: 2070-0011 EXPIRATION DATE: 03/31/2001 RESPS:32 HOURS:10,688 COSTS(000):$0 Polychlorinated Biphenyls (PCBs) Disposal Permitting Regulation FORMS: 1012.06 OMB NO: 2070-0012 EXPIRATION DATE: 01/31/2001 RESPS:218 HOURS:226,547 COSTS(000):$0 Addendum to Existing ICR to Include the Final Rule for Certain Microbial Products of Biotechnology FORMS: 574.10 OMB NO: 2070-0017 EXPIRATION DATE: 08/31/2002 RESPS:7,397 HOURS:30,279 COSTS(000):$0 Recordkeeping and Reporting Requirements for Allegations of Significant Adverse Reactions to Human Health or the Environment -- TSCA Section 8(c) Health and Safety Data Reporting Rule FORMS: 1031.06 OMB NO: 2070-0020 EXPIRATION DATE: 12/31/2002 RESPS:7,000 HOURS:2,100 COSTS(000):$0 Notice of Arrival of Pesticides and Devices FORMS: 3540.1 0152.06 OMB NO: 2070-0021 EXPIRATION DATE: 02/28/2001 RESPS:3 HOURS:18 COSTS(000):$0 Polychlorinated Biphenyls (PCBs): Manufacturing, Processing, and Distribution in Commerce Exemptions FORMS: 857.07 OMB NO: 2070-0024 EXPIRATION DATE: 01/31/2001 RESPS:150 HOURS:216,300 COSTS(000):$0 Maximum Residue Limit (MRL) Petitions on Food/Feed Crops and New Inert Ingredients FORMS: 0597.06 OMB NO: 2070-0026 EXPIRATION DATE: 08/31/2002 RESPS:30 HOURS:84 COSTS(000):$0 FIFRA Section 29 Annual Report on Conditional Registrations FORMS: 0601.06 OMB NO: 2070-0027 EXPIRATION DATE: 08/31/2002 RESPS:2,500 HOURS:21,451 COSTS(000):$0 Foreign Purchaser Acknowledgment Statement of Unregistered Pesticides FORMS: 0161.08 OMB NO: 2070-0028 EXPIRATION DATE: 09/30/2001 RESPS:12,336 HOURS:24,672 COSTS(000):$0 Recordkeeping Requirements for Producers of Pesticides under Section 8 of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) FORMS: 0143.06 OMB NO: 2070-0029 EXPIRATION DATE: 01/31/2001 RESPS:330,644 HOURS:997,222 COSTS(000):$0 Certification of Pesticide Applicators -- 40 CFR Part 171 FORMS: 155.06 OMB NO: 2070-0030 EXPIRATION DATE: 01/31/2003 RESPS:11,000 HOURS:10,400 COSTS(000):$0 Notification of Chemical Exports -- TSCA Section 12(b) FORMS: 0795.10 OMB NO: 2070-0032 EXPIRATION DATE: 09/30/2001 RESPS:422 HOURS:43,466 COSTS(000):$0 Application and Summary Report for an Emergency Exemption for Pesticides FORMS: ICR-0596.06 OMB NO: 2070-0033 EXPIRATION DATE: 01/31/2001 RESPS:278 HOURS:76,450 COSTS(000):$0 TSCA Section 4 Test Rules, Consent Orders and Test Rule Exemptions FORMS: 1139.05 OMB NO: 2070-0038 EXPIRATION DATE: 08/31/2002 RESPS:3 HOURS:1,032 COSTS(000):$0 Significant New Use Rules for Existing Chemicals -- TSCA Section 5(a) FORMS: 1188.06 OMB NO: 2070-0039 EXPIRATION DATE: 01/31/2001 RESPS:45,540 HOURS:120,762 COSTS(000):$0 Submission of Unreasonable Adverse Effects Information under FORMS: 1204.07 OMB NO: 2070-0040 EXPIRATION DATE: 09/30/2003 RESPS:75 HOURS:757 COSTS(000):$0 Application for Experimental use Permit (EUP) to Ship and Use a Pesticide for Experimental Purposes Only FORMS: 0276.11 8570-17 OMB NO: 2070-0044 EXPIRATION DATE: 10/31/2003 RESPS:5,000 HOURS:1,250 COSTS(000):$0 Notice of Supplemental Distribution of a Registered Pesticide Product FORMS: 0278.07 8570-05 OMB NO: 2070-0046 EXPIRATION DATE: 01/31/2001 RESPS:800 HOURS:9,500 COSTS(000):$0 Notification of Substantial Risk of Injury to Health and the Environment under TSCA Section 8(e) FORMS: 0794.08 OMB NO: 2070-0052 EXPIRATION DATE: 01/31/2001 RESPS:449 HOURS:763 COSTS(000):$0 Compliance Requirement for the Child-Resistant Packaging Act FORMS: 616-06 OMB NO: 2070-0054 EXPIRATION DATE: 03/31/2001 RESPS:118 HOURS:3,489 COSTS(000):$0 Preliminary Assessment Information Rule (PAIR) -- TSCA Section 8(a) FORMS: 7710-35 586.08 OMB NO: 2070-0055 EXPIRATION DATE: 08/31/2002 RESPS:349 HOURS:24,604 COSTS(000):$0 Notice of Pesticide Registration by States to Meet a Special Local Need -- Section 24(c) FORMS: 0595.07 8570-25 OMB NO: 2070-0057 EXPIRATION DATE: 01/31/2001 RESPS:139 HOURS:127,741 COSTS(000):$0 Data Call-In for Special Review Chemicals FORMS: 8570-31 8570-32 EPA-0922.05 OMB NO: 2070-0060 EXPIRATION DATE: 04/30/2002 RESPS:12,466 HOURS:187,640 COSTS(000):$0 Application for New or Amended Pesticide Registration FORMS: 8570-1 8570-4 8570-27 8570-34 8570-35 8570-36 8570-37 OMB NO: 2070-0067 EXPIRATION DATE: 01/31/2001 RESPS:4 HOURS:275 COSTS(000):$0 Chemical-Specific Rules -- TSCA Section 8(a) FORMS: 1198.05 OMB NO: 2070-0070 EXPIRATION DATE: 06/30/2001 RESPS:3,000 HOURS:34,500 COSTS(000):$0 Partial Updating of TSCA Inventory Data Base, Production and Site Reports FORMS: 7740.8 1011.04 OMB NO: 2070-0072 EXPIRATION DATE: 09/30/2001 RESPS:2,080 HOURS:47,133 COSTS(000):$0 Reporting and Recordkeeping Requirements for Asbestos Abatement Worker Protection FORMS: EPAICR1246.06 OMB NO: 2070-0074 EXPIRATION DATE: 09/30/2003 RESPS:84 HOURS:3,353 COSTS(000):$0 Recordkeeping for Certified Applicators Using 1080 Collars for Livestock Protection FORMS: 1249.06 OMB NO: 2070-0075 EXPIRATION DATE: 01/31/2001 RESPS:468 HOURS:814 COSTS(000):$0 Request for Contractor Access to TSCA Confidential Business Information FORMS: 7740-6 770 1250.05 OMB NO: 2070-0078 EXPIRATION DATE: 05/31/2002 RESPS:13,262 HOURS:18,173 COSTS(000):$0 Pesticide Registration Application, Notification and Request for Pesticide-Producing Establishments FORMS: 0160.06 3540-8 3540-8A 3540-16 OMB NO: 2070-0081 EXPIRATION DATE: 12/31/2002 RESPS:250 HOURS:1,284 COSTS(000):$0 Wood Preservations, Submission of Information Regarding Arsenic Exposure Levels in Wood Treatment Plants FORMS: 1289.05 OMB NO: 2070-0091 EXPIRATION DATE: 05/31/2001 RESPS:112,721 HOURS:2,367,293 COSTS(000):$0 Asbestos-Containing Materials in Schools Rule and Asbestos Model Accreditiation Plan Rule (MAP) FORMS: 1365.05 OMB NO: 2070-0093 EXPIRATION DATE: 01/31/2003 RESPS:19,990 HOURS:8,825,935 COSTS(000):$0 Final Rule related Amendment to the Existing ICR entitled "Toxic Chemical Release Reporting, Recordkeeping, Supplier Notification and Petitions Under Sec 313 of the EPCRA. FORMS: 1363.10 9350-1 OMB NO: 2070-0100 EXPIRATION DATE: 01/31/2001 RESPS:2,117 HOURS:1,988 COSTS(000):$0 Pesticide Product Reregistration Fees FORMS: 1214.04 OMB NO: 2070-0107 EXPIRATION DATE: 01/31/2001 RESPS:111 HOURS:38,882 COSTS(000):$0 Data Generation for Registration Activities FORMS: 1504.03 OMB NO: 2070-0112 EXPIRATION DATE: 10/31/2001 RESPS:74,461 HOURS:175,453 COSTS(000):$0 PCBs: Notification and Manifesting of PCB Waste Activities and Records of PCB Storage and Disposal FORMS: 7710-53 EPAICR1446.06 OMB NO: 2070-0122 EXPIRATION DATE: 03/31/2001 RESPS:30 HOURS:208,132 COSTS(000):$0 Data Acquisition for Registration FORMS: 1503.03 OMB NO: 2070-0143 EXPIRATION DATE: 02/28/2001 RESPS:9,072 HOURS:646,875 COSTS(000):$0 Alternate Threshold for Low Annual Reportable Amounts, Toxic Chemical Release Reporting FORMS: 9350-2 1704.04 OMB NO: 2070-0145 EXPIRATION DATE: 09/30/2001 RESPS:200 HOURS:200 COSTS(000):$0 Correction of Misreported Chemical Substances on the Toxic Substances Control Act (TSCA) Chemical Substances Inventory FORMS: 7710-3C 1741.02 OMB NO: 2070-0148 EXPIRATION DATE: 09/30/2001 RESPS:8,145,858 HOURS:2,241,633 COSTS(000):$0 Pesticides Worker Protection Standard Training and Notification FORMS: 1759.02 OMB NO: 2070-0151 EXPIRATION DATE: 01/31/2001 RESPS:35,086,878 HOURS:7,143,991 COSTS(000):$0 Residential Lead-Based Paint Hazard Disclosure Requirements FORMS: 1710.02 OMB NO: 2070-0155 EXPIRATION DATE: 01/31/2001 RESPS:28,596 HOURS:403,541 COSTS(000):$0 TSCA Section 402 and Section 404 Training and Certification, Accreditation, and Standards for Lead-based Paint Activities FORMS: 1715.02 OMB NO: 2070-0156 EXPIRATION DATE: 01/31/2001 RESPS:2,697 HOURS:1,348 COSTS(000):$0 Voluntary Cover Sheet for TSCA Submissions FORMS: 1780.01 TBD OMB NO: 2070-0158 EXPIRATION DATE: 09/30/2001 RESPS:18,550,000 HOURS:2,331,597 COSTS(000):$3,622 Lead: Requirements for Hazard Education Before Renovation of Target Housing FORMS: 1669.02 OMB NO: 2070-0159 EXPIRATION DATE: 09/30/2001 RESPS:463,488 HOURS:1,786,153 COSTS(000):$9,771 Disposal of Polychlorinated Biphenyls (PCBs); Final Rule FORMS: 7720-12 7710-53 Office of Research and Development OMB NO: 2080-0005 EXPIRATION DATE: 12/31/2001 RESPS:6 HOURS:6,772 COSTS(000):$19 Revision, Application for Reference and Equivalent Method Determination FORMS: 559.06 OMB NO: 2080-0018 EXPIRATION DATE: 01/31/2002 RESPS:848 HOURS:31,171 COSTS(000):$0 Steam-Electric Plant Operation and Design Report FORMS: 767 OMB NO: 2080-0021 EXPIRATION DATE: 01/31/2001 RESPS:18,000 HOURS:217,243 COSTS(000):$0 Performance Evaluation Studies on Water and Wastewater FORMS: 234.06 OMB NO: 2080-0033 EXPIRATION DATE: 01/31/2001 RESPS:1,497 HOURS:55,635 COSTS(000):$0 Quality Assurance Specification and Requirements FORMS: 866.05 OMB NO: 2080-0048 EXPIRATION DATE: 01/31/2001 RESPS:1,511 HOURS:1,620 COSTS(000):$0 Request for Information for Bioremediation Field Initiative FORMS: 3248 1672.02 OMB NO: 2080-0050 EXPIRATION DATE: 04/30/2003 RESPS:1,800 HOURS:12,240 COSTS(000):$0 Evaluation of the Burden of Waterborne Disease Within Communities in the United States FORMS: 1727.02 OMB NO: 2080-0057 EXPIRATION DATE: 02/28/2002 RESPS:8,600 HOURS:1,720 COSTS(000):$0 EPA EMPACT Urban Environmental Issues Study of 86 Cities FORMS: 1864.01 OMB NO: 2080-0058 EXPIRATION DATE: 07/31/2002 RESPS:30 HOURS:2,090 COSTS(000):$0 Personal Exposure of High-Risk Subpopulations to Particles FORMS: 1887.01 OMB NO: 2080-0061 EXPIRATION DATE: 03/31/2003 RESPS:2,834 HOURS:657 COSTS(000):$0 A Polity Study of Children's Total Exposure to Persistent Pesticides and Other Persistent Organic Pollutants FORMS: 1892.02 OMB NO: 2080-0063 EXPIRATION DATE: 02/28/2003 RESPS:1,674 HOURS:349 COSTS(000):$0 Agricultural Health Study: Pesticide Exposure Study FORMS: 1906.01 OMB NO: 2080-0065 EXPIRATION DATE: 09/30/2003 RESPS:13,400 HOURS:5,145 COSTS(000):$0 Health Effects of Particulate Matter and Co-pollutant Exposures Near the EI Paso/Juarez Border Crossings FORMS: 1940.02 Office of the Administrator OMB NO: 2090-0003 EXPIRATION DATE: 03/31/2001 RESPS:1 HOURS:52 COSTS(000):$0 Beach Closing Survey Report on the Great Lakes FORMS: 0994.06 OMB NO: 2090-0014 EXPIRATION DATE: 02/28/2003 RESPS:13,100 HOURS:6,550 COSTS(000):$0 Pre-Award Compliance Review Report for All Applicants Requesting Federal Financial Assistance FORMS: 4700-4 0275.07 OMB NO: 2090-0019 EXPIRATION DATE: 03/31/2003 RESPS:68,740 HOURS:15,536 COSTS(000):$0 Voluntary Customer Service Satisfaction Surveys FORMS: 1711.03
(RETURN TO AGENCY LIST)OMB NO: 3046-0003 EXPIRATION DATE: 05/31/2002 RESPS:5,000 HOURS:12,000 COSTS(000):$100 Elementary-Secondary Staff Information -- EEO-5 FORMS: 168A OMB NO: 3046-0006 EXPIRATION DATE: 02/28/2003 RESPS:3,000 HOURS:4,500 COSTS(000):$0 Local Union Report (EEO-3) FORMS: 274 OMB NO: 3046-0007 EXPIRATION DATE: 11/30/2002 RESPS:170,000 HOURS:402,700 COSTS(000):$0 Employer Information Report -- EEO-1 FORMS: 100 OMB NO: 3046-0008 EXPIRATION DATE: 07/31/2003 RESPS:10,000 HOURS:40,000 COSTS(000):$0 State and Local Government (EEO-4) FORMS: 164 OMB NO: 3046-0017 EXPIRATION DATE: 12/31/2001 RESPS:666,000 HOURS:1,450,000 COSTS(000):$0 Uniform Guidelines on Employee Selection Procedures FORMS: NONE OMB NO: 3046-0040 EXPIRATION DATE: 08/31/2003 RESPS:627,000 HOURS:16,677 COSTS(000):$0 Recordkeeping and Reporting under Title VII and the ADA FORMS: NONE OMB NO: 3046-0043 EXPIRATION DATE: 07/31/2003 RESPS:1 HOURS:41,000 COSTS(000):$0 Waiver of Rights and Claims Under the Age Discrimination in Employment Act (ADEA) FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency OMB NO: 3048-0003 EXPIRATION DATE: 01/31/2001 RESPS:600 HOURS:1,200 COSTS(000):$0 U.S. Small Business Administration, Export-Import Bank of the United States, Joint Application for Working Capital Guarantee FORMS: EIB-SBA FORM-84-1 OMB NO: 3048-0004 EXPIRATION DATE: 05/31/2003 RESPS:50 HOURS:50 COSTS(000):$0 Annual Competitiveness Report Survey of Exporters and Bankers FORMS: EIB-00-02 OMB NO: 3048-0005 EXPIRATION DATE: 07/31/2001 RESPS:960 HOURS:310 COSTS(000):$0 Ex-Im Bank letter of Interest Application Form FORMS: EIB-95-9 OMB NO: 3048-0009 EXPIRATION DATE: 05/31/2002 RESPS:2,112 HOURS:2,262 COSTS(000):$0 Application froms for export credit insurance program FORMS: EIB-92-34 EIB-92-41 EIB-92-45 EIB-92-50 EIB-92-64 EIB-92-72 EIB-92-79 EIB-92-48 OMB NO: 3048-0011 EXPIRATION DATE: 09/30/2001 RESPS:400 HOURS:133 COSTS(000):$0 Export Import Bank of the United States Customer Service Satisfaction Form FORMS: EIB-95-7
(RETURN TO AGENCY LIST)OMB NO: 3067-0001 EXPIRATION DATE: 03/31/2003 RESPS:50 HOURS:25 COSTS(000):$0 National Defense Executive Reserve Personal Qualification Statement FORMS: FEMA-85-3 OMB NO: 3067-0009 EXPIRATION DATE: 02/28/2003 RESPS:460,900 HOURS:171,148 COSTS(000):$0 Disaster Assistance Registration; Applicant Statement/Authorization; Declaration of Applicant FORMS: FEMA-90-69 FEMA-90-69A FEMA-90-69B FEMA-90-69C FEMA-90-69D FEMA-90-69E OMB NO: 3067-0018 EXPIRATION DATE: 03/31/2002 RESPS:9,098 HOURS:7,546 COSTS(000):$5,977 National Flood Insurance Program Biennial Report FORMS: FORMS-81-28 81-29 81-29A OMB NO: 3067-0020 EXPIRATION DATE: 03/31/2002 RESPS:100 HOURS:400 COSTS(000):$0 Application for Participation in the National Flood Insurance Program FORMS: FEMA-81-64 OMB NO: 3067-0021 EXPIRATION DATE: 12/31/2003 RESPS:77,634 HOURS:310,536 COSTS(000):$0 Claims for National Flood Insurance Program (NFIP) FORMS: 81-40 81-41 81-41A 81-42 81-42A 81-43 81-44 81-57 81-58 81-59 OMB NO: 3067-0022 EXPIRATION DATE: 02/28/2003 RESPS:317,601 HOURS:31,718 COSTS(000):$16,856 National Flood Insurance Policy Forms FORMS: 81-16 81-17 81-18 81-25 81-67 OMB NO: 3067-0024 EXPIRATION DATE: 07/31/2003 RESPS:65,000 HOURS:8,500 COSTS(000):$0 General Admissions Applications and General Admissions Application Short Form FORMS: FEMA-FORM-75-5 FEMA-FORM-75-5A OMB NO: 3067-0066 EXPIRATION DATE: 08/31/2002 RESPS:27 HOURS:138 COSTS(000):$1,654 Request for Fire Suppression Assistance FORMS: SF-424 SF-269A SF-270 FEMA90-58 FEMA90-91 OMB NO: 3067-0077 EXPIRATION DATE: 07/31/2002 RESPS:73,650 HOURS:166,362 COSTS(000):$0 Post Construction Elevation Certificate/Floodproofing Certificate FORMS: 81-31 81-65 OMB NO: 3067-0113 EXPIRATION DATE: 11/30/2002 RESPS:174 HOURS:13,224 COSTS(000):$0 The Declaration Process: Request for Damage Assessment, Federal Disaster Assistance, Cost Share Adjustment, and Loans of the Non-Federal Share FORMS: NONE OMB NO: 3067-0120 EXPIRATION DATE: 06/30/2001 RESPS:50 HOURS:75 COSTS(000):$0 Implementation of Coastal Barrier Resources Act FORMS: NONE OMB NO: 3067-0122 EXPIRATION DATE: 06/30/2001 RESPS:2,000 HOURS:1,500 COSTS(000):$0 Debt Collection Financial Statement FORMS: FEMA-FORM-22-13 OMB NO: 3067-0125 EXPIRATION DATE: 09/30/2003 RESPS:520 HOURS:86 COSTS(000):$0 Request for Loan Information Verification FORMS: FEMA-FORM-90-68 OMB NO: 3067-0127 EXPIRATION DATE: 03/31/2002 RESPS:20 HOURS:100 COSTS(000):$0 Exemption of State-Owned Properties under Self-Insurance Plan FORMS: NONE OMB NO: 3067-0138 EXPIRATION DATE: 10/31/2001 RESPS:56 HOURS:1,120 COSTS(000):$0 State Administrative Plan FORMS: NONE OMB NO: 3067-0141 EXPIRATION DATE: 08/31/2002 RESPS:16 HOURS:24 COSTS(000):$0 Reimbursement for Cost of Firefighting on Federal Property FORMS: NONE OMB NO: 3067-0146 EXPIRATION DATE: 10/31/2001 RESPS:56 HOURS:168 COSTS(000):$0 State Administrative Plans for the Individual Family Grant Program FORMS: NONE OMB NO: 3067-0147 EXPIRATION DATE: 05/31/2001 RESPS:5,400 HOURS:22,788 COSTS(000):$0 Report to Submit Technical or Scientific Data to Correct Mapping Deficiencies Unrelated to Community-Wide Elevation Determinations (Amendments & Revisions to National Flood Insurance Program Map) FORMS: 81-87 81-87A 81-87B 81-87C 81-87D 81-87E OMB NO: 3067-0148 EXPIRATION DATE: 04/30/2001 RESPS:900 HOURS:7,074 COSTS(000):$0 Consultation with Local Officials to Assure Compliance with Sections 110 and 206 of the Flood Disaster Protection Act of 1973 (Revisions to National Flood Insurance Program Maps) FORMS: 81-89/81-89A 81-89B/81-89C 81-89D/81-89E 81-89F/81-89G 81-89H/81-89I 81-89J/81-89K OMB NO: 3067-0151 EXPIRATION DATE: 04/30/2001 RESPS:100 HOURS:125 COSTS(000):$0 Progress Report FORMS: NONE OMB NO: 3067-0163 EXPIRATION DATE: 01/31/2001 RESPS:7,362 HOURS:814 COSTS(000):$0 Individual and Family Grant (IFG) Program FORMS: 76-27 76-28 76-29 76-32 76-34 76-38 OMB NO: 3067-0166 EXPIRATION DATE: 03/31/2002 RESPS:92 HOURS:4,896 COSTS(000):$0 Crisis Counseling Assistance and Training Program FORMS: SF-424 OMB NO: 3067-0167 EXPIRATION DATE: 03/31/2002 RESPS:7 HOURS:7 COSTS(000):$0 Claims of Federal Personnel for Personal Property Damage or Loss FORMS: NONE OMB NO: 3067-0169 EXPIRATION DATE: 03/31/2002 RESPS:1,440 HOURS:792 COSTS(000):$0 Write Your Own (WYO) Program FORMS: NONE OMB NO: 3067-0194 EXPIRATION DATE: 04/30/2001 RESPS:300 HOURS:300 COSTS(000):$0 National Fire Academy Executive Fire Officer Program Application for Admission FORMS: FEMA-FORM-95-22 OMB NO: 3067-0195 EXPIRATION DATE: 09/30/2001 RESPS:940 HOURS:9,260 COSTS(000):$0 Community Rating System (CRS) Program, Application Worksheets and Commentary FORMS: 81-83 FIA-15 OMB NO: 3067-0198 EXPIRATION DATE: 03/31/2002 RESPS:3,800 HOURS:15,200 COSTS(000):$0 Efectiveness of a Community's Implementation of the NFIP, Community Assistance Contact Report and Community Assistance Visit Report FORMS: FEMA-81-68 FEMA-81-69 OMB NO: 3067-0201 EXPIRATION DATE: 04/30/2002 RESPS:1 HOURS:160 COSTS(000):$0 Federal Assistance for Offsite Radiological Emergency Planning and Preparedness under Executive Order 12657 FORMS: NONE OMB NO: 3067-0208 EXPIRATION DATE: 12/31/2003 RESPS:26 HOURS:205 COSTS(000):$0 State Administrative Plan for the Hazardous Mitigation Grant Program FORMS: NONE OMB NO: 3067-0212 EXPIRATION DATE: 09/30/2003 RESPS:26 HOURS:4,160 COSTS(000):$106 Hazard Mitigation Planning/State Hazard Mitigation Plan FORMS: NONE OMB NO: 3067-0213 EXPIRATION DATE: 06/30/2001 RESPS:10 HOURS:30 COSTS(000):$0 FEMA Contract Clause, Accessibility of Meetings to Persons with Disabilities FORMS: NONE OMB NO: 3067-0219 EXPIRATION DATE: 12/31/2003 RESPS:1,200 HOURS:130 COSTS(000):$3,000 Approval and Coordination of Requirements to use the NETC for Extracurricular Training Activities FORMS: 75-10 75-11 OMB NO: 3067-0222 EXPIRATION DATE: 04/30/2002 RESPS:1,000 HOURS:333 COSTS(000):$0 Request for Site Inspection, Landowners Authorization/Ingress/ Engress Agreement FORMS: 90-1 90-31 OMB NO: 3067-0233 EXPIRATION DATE: 03/31/2002 RESPS:25,000 HOURS:6,250 COSTS(000):$0 National Fire Academy Field Course Evaluation Form FORMS: FEMA-FORM-95-45 OMB NO: 3067-0234 EXPIRATION DATE: 12/31/2003 RESPS:5,500 HOURS:1,375 COSTS(000):$0 National Fire Academy Resident Course Evaluation Form FORMS: FEMA-FORM-95-20 OMB NO: 3067-0235 EXPIRATION DATE: 09/30/2003 RESPS:50 HOURS:163 COSTS(000):$0 Residential Basement Floodproofing Certificate FORMS: FEMA-FORM-81-78 OMB NO: 3067-0237 EXPIRATION DATE: 02/28/2002 RESPS:4,000 HOURS:667 COSTS(000):$0 Emergency Management Institute Resident Course Evaluation Form FORMS: FEMA-FORM-95-41 OMB NO: 3067-0256 EXPIRATION DATE: 02/28/2001 RESPS:233,256 HOURS:58,316 COSTS(000):$0 Federal Emergency Management Agency (FEMA) Individual Disaster Assistance Customer Satisfaction and Program Effectiveness Surveys FORMS: NONE OMB NO: 3067-0257 EXPIRATION DATE: 04/30/2001 RESPS:5,854 HOURS:14,050 COSTS(000):$0 Report to Submit Technical Data to Correct Mapping Deficiencies Unrelated to Community-Wide Elevation Determinations for a Single Residential Lot or Structure FORMS: FEMA-FORM-81-92 OMB NO: 3067-0259 EXPIRATION DATE: 04/30/2002 RESPS:5 HOURS:35 COSTS(000):$0 Write You Own (WYO) Company Participation Criteria; New Applicants FORMS: NONE OMB NO: 3067-0260 EXPIRATION DATE: 04/30/2002 RESPS:1,500 HOURS:375 COSTS(000):$0 National Fire Academy Long-Term Course Evaluation Forms FORMS: NETC-F-8872 NETC-F-8873 OMB NO: 3067-0264 EXPIRATION DATE: 10/31/2001 RESPS:12,000,000 HOURS:4,000,000 COSTS(000):$0 Standard Flood Hazard Determination FORMS: 81-93 OMB NO: 3067-0267 EXPIRATION DATE: 02/28/2001 RESPS:7,138 HOURS:3,082 COSTS(000):$1,150 The Federal Emergency Management Agency/Federal Insurance Administration's Cover America II Project FORMS: NONE OMB NO: 3067-0268 EXPIRATION DATE: 07/31/2003 RESPS:7,500 HOURS:2,500 COSTS(000):$0 Make Your Mark on the Floodplain-High Water Mark Form FORMS: FORM-81-101 OMB NO: 3067-0271 EXPIRATION DATE: 03/31/2002 RESPS:616 HOURS:116,624 COSTS(000):$0 Flood Mitigation Assistance, Flood Mitigation Plan FORMS: NONE OMB NO: 3067-0272 EXPIRATION DATE: 04/30/2001 RESPS:56 HOURS:3,360 COSTS(000):$87 Capability Assessment for Readiness (CAR) FORMS: NONE OMB NO: 3067-0273 EXPIRATION DATE: 11/30/2001 RESPS:4,000 HOURS:1,000 COSTS(000):$0 Emergency Management Institute Follow-Up Evaluation Survey FORMS: FEMA-FORM-95-56 OMB NO: 3067-0275 EXPIRATION DATE: 07/31/2002 RESPS:1,100 HOURS:3,300 COSTS(000):$72 Inspection of Insured Structures by Communities FORMS: NONE OMB NO: 3067-0277 EXPIRATION DATE: 01/31/2001 RESPS:70,000 HOURS:1,167 COSTS(000):$21 EMI Independent Study Course Enrollment Application FORMS: 95-23 OMB NO: 3067-0278 EXPIRATION DATE: 01/31/2001 RESPS:56 HOURS:182 COSTS(000):$0 Request for Federal Assistance Form -- How to Process Mission Assignments in Federal Disaster Operations FORMS: NONE OMB NO: 3067-0279 EXPIRATION DATE: 01/31/2001 RESPS:213 HOURS:48,789 COSTS(000):$0 Hurricane Floyd Special Buyout Authority Application and Reporting FORMS: SF-424 FEMA-FORMS20-15 20-10 20-16 20-16A 20-16C SF-LLL OMB NO: 3067-0280 EXPIRATION DATE: 01/31/2001 RESPS:18,000 HOURS:13,500 COSTS(000):$6 Notice of Loss--Cerro Grande Fire Assistance Act FORMS: NONE OMB NO: 3067-0281 EXPIRATION DATE: 12/31/2003 RESPS:300 HOURS:235 COSTS(000):$0 Closed-Basin Lake Endorsement FORMS: 81-42 81-42A 81-43 OMB NO: 3067-0282 EXPIRATION DATE: 03/31/2001 RESPS:18,000 HOURS:405,000 COSTS(000):$0 Proof of Loss Form - Cerro Grande Fire Assistance Claims FORMS: NONE OMB NO: 3067-0283 EXPIRATION DATE: 12/31/2003 RESPS:178 HOURS:356 COSTS(000):$9 Project Impact Baseline Report and Progress Report FORMS: NONE OMB NO: 3067-0284 EXPIRATION DATE: 04/30/2001 RESPS:5,000 HOURS:20,000 COSTS(000):$0 Subrogation Notice and Proof of Loss--Cerro Grande Fire Assistance Act FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3139-0004 EXPIRATION DATE: 12/31/2001 RESPS:50 HOURS:17 COSTS(000):$0 Rules Pertaining to the Privacy of Individuals and Systems of Records Maintained by the Appraisals Subcommittee -- 12 CFR Part 1102, Subpart C FORMS: NONE OMB NO: 3139-0005 EXPIRATION DATE: 09/30/2002 RESPS:2 HOURS:120 COSTS(000):$0 Rules of Practice for Proceedings -- 12 CFR Part 1102, Subpart B FORMS: NONE OMB NO: 3139-0006 EXPIRATION DATE: 12/31/2002 RESPS:11 HOURS:4 COSTS(000):$0 Description of Office, Procedures, Public Information 12 CFR Part 102, Subpart D FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3070-0007 EXPIRATION DATE: 07/31/2001 RESPS:160 HOURS:80 COSTS(000):$0 Federal Service Impasses Panel, Request for Assistance FORMS: FLRA-14
(RETURN TO AGENCY LIST)OMB NO: 3076-0001 EXPIRATION DATE: 11/30/2001 RESPS:250 HOURS:375 COSTS(000):$0 Arbitrator's Personal Data Questionnaire FORMS: FMCS-R-22 OMB NO: 3076-0002 EXPIRATION DATE: 11/30/2001 RESPS:15,000 HOURS:2,500 COSTS(000):$450 The Request for Arbitration Services FORMS: FMCS-R-43 OMB NO: 3076-0003 EXPIRATION DATE: 11/30/2001 RESPS:4,000 HOURS:834 COSTS(000):$0 Arbitrator's Report and Fee Statement FORMS: FMCS-R-19 OMB NO: 3076-0006 EXPIRATION DATE: 01/31/2002 RESPS:404 HOURS:251 COSTS(000):$0 FMCS Grants Program and Grant Evaluation Package FORMS: SF-424 SF-270(LM-6) (LM-8) SF-269A(LM-7) (LM-9) (LM-3) OMB NO: 3076-0014 EXPIRATION DATE: 01/31/2001 RESPS:1,600 HOURS:800 COSTS(000):$0 National Customer Survey FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3090-0007 EXPIRATION DATE: 10/31/2001 RESPS:6,986 HOURS:17,465 COSTS(000):$0 Contractor's Qualifications and Financial Information FORMS: GSA-527 OMB NO: 3090-0014 EXPIRATION DATE: 09/30/2001 RESPS:63,000 HOURS:25,000 COSTS(000):$18,900 Transfer Order - Surplus Personal Property and Continuation Sheet FORMS: SF-123 SF-123-A OMB NO: 3090-0021 EXPIRATION DATE: 08/31/2003 RESPS:1 HOURS:250 COSTS(000):$0 Profit and Loss Statement - Operating Statement FORMS: GSA-2817 OMB NO: 3090-0023 EXPIRATION DATE: 10/31/2001 RESPS:35,000 HOURS:2,905 COSTS(000):$0 Surplus Personal Property Mailing List Application FORMS: GSA-2170 OMB NO: 3090-0027 EXPIRATION DATE: 09/30/2001 RESPS:33,600 HOURS:2,800 COSTS(000):$0 Contract Administration, Quality Assurance -- General Services Administration Acquisition Regulation (GSAR) Part 542 and Part 546 FORMS: GSA-1678 OMB NO: 3090-0040 EXPIRATION DATE: 02/28/2001 RESPS:4,000 HOURS:1,333 COSTS(000):$0 Application for Shipping Instructions and Notice of Availability FORMS: GSA-1611 OMB NO: 3090-0043 EXPIRATION DATE: 09/30/2001 RESPS:1,300 HOURS:2,200 COSTS(000):$0 Appraisal of Fair Annual Parking Rate Per Space for Standard Level User Charge FORMS: GSA-FORM-3357 OMB NO: 3090-0057 EXPIRATION DATE: 06/30/2001 RESPS:500 HOURS:125 COSTS(000):$2,870 Deposit Bond Individual, Sale of Government Personal Property FORMS: SF-150 OMB NO: 3090-0058 EXPIRATION DATE: 06/30/2001 RESPS:1,000 HOURS:250 COSTS(000):$5,740 Deposit Bond, Annual Sale of Government Personal Property FORMS: SF-151 OMB NO: 3090-0080 EXPIRATION DATE: 09/30/2001 RESPS:2,000 HOURS:200 COSTS(000):$0 Contract Financing -- General Services Administration Acquisition Regulations (GSAR) Part 532 FORMS: GSA-1142 OMB NO: 3090-0093 EXPIRATION DATE: 06/30/2001 RESPS:160 HOURS:160 COSTS(000):$0 Transportation Discrepancy Report -- SF-361 FORMS: SF-361 OMB NO: 3090-0112 EXPIRATION DATE: 10/31/2001 RESPS:220 HOURS:220 COSTS(000):$6,732 State Agency Monthly Donation Report of Surplus Personal Property FORMS: GSA-3040 OMB NO: 3090-0118 EXPIRATION DATE: 06/30/2001 RESPS:816 HOURS:272 COSTS(000):$0 Statement of Witness -- Standard Form 94 FORMS: SF-94 OMB NO: 3090-0121 EXPIRATION DATE: 06/30/2001 RESPS:119,640 HOURS:997 COSTS(000):$0 Establishing and Administering Schedules -- General Services Administration Acquisition Regulation (GSAR) Part 538.2 FORMS: GSA-72A OMB NO: 3090-0197 EXPIRATION DATE: 06/30/2001 RESPS:2,200 HOURS:2,200 COSTS(000):$0 Service Contracting -- General Services Administration Acquistion Regulation (GSAR) Part 537 FORMS: NONE OMB NO: 3090-0198 EXPIRATION DATE: 09/30/2001 RESPS:9 HOURS:1.5 COSTS(000):$0 Foreign Acquisition -- General Services Administration Acquisition Regulation (GSAR) Part 525 FORMS: NONE OMB NO: 3090-0200 EXPIRATION DATE: 06/30/2001 RESPS:20 HOURS:3 COSTS(000):$0 Sealed Bidding -- General Services Administration Acquisition Regulation (GSAR) Part 514 FORMS: NONE OMB NO: 3090-0221 EXPIRATION DATE: 01/31/2001 RESPS:86 HOURS:10 COSTS(000):$0 GSA Board of Contract Appeals Subpoena, GSA Board of Contract Appeals Forms 4 and 5 (Certificates of Finality) FORMS: GSA-9534 OMB NO: 3090-0227 EXPIRATION DATE: 06/30/2001 RESPS:60 HOURS:150 COSTS(000):$0 Termination Liability Schedule -- GSAR Part 549 FORMS: NONE OMB NO: 3090-0235 EXPIRATION DATE: 01/31/2002 RESPS:13,724 HOURS:102,930 COSTS(000):$412 GSA Schedule Contracting, Price Reductions Clause -- 48 CFR 552.238-76, General Services Administration Acquisition Regulation (GSAR) Part 538 FORMS: NONE OMB NO: 3090-0243 EXPIRATION DATE: 06/30/2001 RESPS:4,371 HOURS:2,186 COSTS(000):$0 General Services Administration Acquisition Regulation (GSAR) Part 516.2 Fixed-Price Contracts FORMS: NONE OMB NO: 3090-0246 EXPIRATION DATE: 10/31/2001 RESPS:931,219 HOURS:875 COSTS(000):$0 General Services Administration Acquisition Regulation (GSAR) Packing List Clause FORMS: NONE OMB NO: 3090-0248 EXPIRATION DATE: 05/31/2002 RESPS:260 HOURS:260 COSTS(000):$0 48 CFR 552.216-73 Placement of Orders 48 CFR 552.216-74 Ordering Information FORMS: NONE OMB NO: 3090-0250 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Zero Burden Information Collection Reports FORMS: NONE OMB NO: 3090-0252 EXPIRATION DATE: 05/31/2002 RESPS:1,350 HOURS:16,200 COSTS(000):$0 Preparation, Submission, and Negotiation of Subcontracting Plans FORMS: NONE OMB NO: 3090-0259 EXPIRATION DATE: 03/31/2002 RESPS:25 HOURS:60 COSTS(000):$0 Market Research Questionnaire FORMS: NONE OMB NO: 3090-0260 EXPIRATION DATE: 11/30/2001 RESPS:200 HOURS:20 COSTS(000):$0 Questionnaire: Catalog of Federal Domestic Assistance FORMS: NONE OMB NO: 3090-0262 EXPIRATION DATE: 10/31/2001 RESPS:1 HOURS:16,000 COSTS(000):$32 Identification of Products with Environmental Attributes FORMS: NONE OMB NO: 3090-0270 EXPIRATION DATE: 08/31/2002 RESPS:100,000 HOURS:250,000 COSTS(000):$0 Access Certificates for Electronic Services (ACES) FORMS: NONE OMB NO: 3090-0271 EXPIRATION DATE: 04/30/2003 RESPS:23,400 HOURS:3,900 COSTS(000):$0 American Customer Satisfaction Index (ACSI) FORMS: NONE OMB NO: 3090-0273 EXPIRATION DATE: 04/30/2003 RESPS:1,000 HOURS:50 COSTS(000):$0 Questionnaire: CD-ROM of the Ctalog of Federal Domestic Assistance and Federal Assistance Award Data System FORMS: NONE OMB NO: 3090-0274 EXPIRATION DATE: 05/31/2003 RESPS:360 HOURS:90 COSTS(000):$2 Art-in-Architecture Program National Artist Registry FORMS: GSA-7437 OMB NO: 3090-0275 EXPIRATION DATE: 10/31/2003 RESPS:50 HOURS:1,250 COSTS(000):$0 Child Care Subsidy Application - Main Provider FORMS: GSA-3674A
(RETURN TO AGENCY LIST)No active collections for this agency No active collections for this agency No active collections for this agency OMB NO: 3117-0016 EXPIRATION DATE: 07/31/2002 RESPS:4,375 HOURS:175,000 COSTS(000):$13,125 Information Collections for Import Injury Investigations Questionnaires and Institution Notices for 5-Year Reviews) FORMS: NONE OMB NO: 3117-0188 EXPIRATION DATE: 11/30/2002 RESPS:1,500 HOURS:375 COSTS(000):$0 ITC Reader Satisfaction Survey FORMS: NONE OMB NO: 3117-0190 EXPIRATION DATE: 01/31/2003 RESPS:2,000 HOURS:66 COSTS(000):$0 ITC DataWeb: User Registration Forms FORMS: NONE OMB NO: 3117-0192 EXPIRATION DATE: 08/31/2002 RESPS:50 HOURS:50 COSTS(000):$0 Survey for Participants in Commission Import Injury Investigations FORMS: NONE OMB NO: 3117-0196 EXPIRATION DATE: 09/30/2002 RESPS:1 HOURS:37 COSTS(000):$0 Survey Regarding Outstanding Sec. 337 Exclusion Orders FORMS: NONE OMB NO: 3117-0198 EXPIRATION DATE: 08/31/2003 RESPS:12 HOURS:240 COSTS(000):$0 U.S. Producers Questionnaire - Competitive Assessment of the U.S. Large Civil Aircraft Aerostructures Industry FORMS: NONE OMB NO: 3117-0199 EXPIRATION DATE: 01/31/2001 RESPS:100 HOURS:100 COSTS(000):$0 The Economic Impact on the United States of the EU-South Africa Trade Agreement FORMS: 332-416
(RETURN TO AGENCY LIST)No active collections for this agency No active collections for this agency OMB NO: 3124-0009 EXPIRATION DATE: 12/31/2003 RESPS:9,000 HOURS:4,500 COSTS(000):$0 U.S. Merit Systems Protection Board Appeal Form (OF-283) FORMS: NONE OMB NO: 3124-0012 EXPIRATION DATE: 04/30/2001 RESPS:3,750 HOURS:937 COSTS(000):$0 Customer Surveys FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 2700-0003 EXPIRATION DATE: 06/30/2001 RESPS:10,200 HOURS:91,500 COSTS(000):$0 NASA Contractor Financial Management Reports FORMS: NASA-533M NASA-533Q OMB NO: 2700-0007 EXPIRATION DATE: 09/30/2001 RESPS:100 HOURS:29 COSTS(000):$986 Radioactive Material Transfer Receipt FORMS: JSC-1625 OMB NO: 2700-0009 EXPIRATION DATE: 04/30/2001 RESPS:1,100 HOURS:550 COSTS(000):$0 AST Technology Utilization FORMS: NASA-1679 OMB NO: 2700-0010 EXPIRATION DATE: 09/30/2003 RESPS:60 HOURS:30 COSTS(000):$0 Patent License Report FORMS: NONE OMB NO: 2700-0017 EXPIRATION DATE: 12/31/2001 RESPS:1 HOURS:8,144 COSTS(000):$0 NASA Property in the Custody of Contractors FORMS: NASA-1018 OMB NO: 2700-0039 EXPIRATION DATE: 09/30/2003 RESPS:80 HOURS:640 COSTS(000):$0 Application for a Patent License FORMS: NONE OMB NO: 2700-0047 EXPIRATION DATE: 09/30/2001 RESPS:28,596 HOURS:117,925 COSTS(000):$0 Property Management and Controls, Grants FORMS: NONE OMB NO: 2700-0048 EXPIRATION DATE: 09/30/2003 RESPS:9,347 HOURS:17,276 COSTS(000):$0 Patents FORMS: NONE OMB NO: 2700-0049 EXPIRATION DATE: 09/30/2001 RESPS:37,696 HOURS:295,760 COSTS(000):$0 Financial Monitoring and Control, Grants FORMS: NONE OMB NO: 2700-0050 EXPIRATION DATE: 08/31/2001 RESPS:66 HOURS:147 COSTS(000):$0 Patent Waiver Report FORMS: NASA-1393 OMB NO: 2700-0052 EXPIRATION DATE: 05/31/2001 RESPS:3,557 HOURS:13,795 COSTS(000):$0 Patents, Data, and Copyrights -- NASA FAR Supplement Part 1827 FORMS: NONE OMB NO: 2700-0054 EXPIRATION DATE: 09/30/2001 RESPS:176 HOURS:8,645 COSTS(000):$0 Contract Modifications -- NASA FAR Supplement Part 18-43 FORMS: NONE OMB NO: 2700-0057 EXPIRATION DATE: 11/30/2001 RESPS:25 HOURS:25 COSTS(000):$0 Application for Volunteer Program FORMS: NONE OMB NO: 2700-0063 EXPIRATION DATE: 05/31/2003 RESPS:75 HOURS:19 COSTS(000):$0 NASA Safety Reporting System FORMS: NONE OMB NO: 2700-0064 EXPIRATION DATE: 10/31/2003 RESPS:8,456 HOURS:702 COSTS(000):$0 Locator and Information Services Tracking System (LISTS) Form FORMS: GSFC-24-27 OMB NO: 2700-0073 EXPIRATION DATE: 09/30/2001 RESPS:450 HOURS:5,500 COSTS(000):$0 Small Business and Small Disadvantaged Business Concerns and SF-295 FORMS: NONE OMB NO: 2700-0078 EXPIRATION DATE: 09/30/2003 RESPS:96 HOURS:140 COSTS(000):$0 Small Business and Small Disadvantaged Business Concerns FORMS: NONE OMB NO: 2700-0080 EXPIRATION DATE: 09/30/2003 RESPS:650 HOURS:2,113 COSTS(000):$0 Uncompensated Overtime FORMS: NONE OMB NO: 2700-0084 EXPIRATION DATE: 11/30/2001 RESPS:248 HOURS:62 COSTS(000):$0 Grants Proposal Writers and Peer Reviewers Customer Satisfaction Surveys FORMS: NONE OMB NO: 2700-0085 EXPIRATION DATE: 11/30/2003 RESPS:1,496 HOURS:663,816 COSTS(000):$0 NASA Acquisition Process, bids and proposals for contracts with an estimated value mor than $500,000. FORMS: NONE OMB NO: 2700-0086 EXPIRATION DATE: 11/30/2003 RESPS:250,865 HOURS:73,380 COSTS(000):$0 NASA Acquisition Process, Purchase orders for goods and services with an estimated value of $100,000 or less FORMS: NONE OMB NO: 2700-0087 EXPIRATION DATE: 11/30/2003 RESPS:11,000 HOURS:2,790,000 COSTS(000):$0 NASA Acquisition Process, bids and proposals for contracts with an estimated value less than $500,000. FORMS: NONE OMB NO: 2700-0088 EXPIRATION DATE: 09/30/2001 RESPS:38,460 HOURS:2,050,380 COSTS(000):$0 NASA Acquisition Process, Reports Required under Contracts with FORMS: NONE OMB NO: 2700-0089 EXPIRATION DATE: 11/30/2003 RESPS:76,160 HOURS:609,280 COSTS(000):$0 NASA Acquisiiton Process, reports required for contracts with an estimated value more than $500,000. FORMS: NONE OMB NO: 2700-0092 EXPIRATION DATE: 09/30/2001 RESPS:658 HOURS:17,660 COSTS(000):$0 Cooperative Agreements with Commercial firms FORMS: NONE OMB NO: 2700-0093 EXPIRATION DATE: 09/30/2001 RESPS:95 HOURS:620 COSTS(000):$0 Grants and Cooperative Agreements with State and Local FORMS: NONE OMB NO: 2700-0094 EXPIRATION DATE: 12/31/2001 RESPS:11.25 HOURS:506 COSTS(000):$0 Cost Reduction Proposals under the NASA FAR Supplement FORMS: NONE OMB NO: 2700-0095 EXPIRATION DATE: 03/31/2003 RESPS:200 HOURS:200 COSTS(000):$0 NASA Small Business Innovative Research Commercial Metrics FORMS: NONE OMB NO: 2700-0096 EXPIRATION DATE: 04/30/2002 RESPS:300 HOURS:75 COSTS(000):$0 NASA Commercial Technology Program Client Feedback Survey FORMS: NONE OMB NO: 2700-0097 EXPIRATION DATE: 12/31/2002 RESPS:10,120 HOURS:5,060 COSTS(000):$0 Required Central Contractor Registration FORMS: NONE OMB NO: 2700-0098 EXPIRATION DATE: 03/31/2003 RESPS:400 HOURS:188,000 COSTS(000):$0 Security Requirements for Unclassified Information Technology Resources FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3095-0002 EXPIRATION DATE: 07/31/2001 RESPS:1 HOURS:7 COSTS(000):$0 Statistical Research in Archival Records Containing Personal Information FORMS: NONE OMB NO: 3095-0004 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:552 COSTS(000):$8 NHPRC Budget Form and Instructions FORMS: NA-17001 OMB NO: 3095-0007 EXPIRATION DATE: 01/31/2001 RESPS:3,200 HOURS:267 COSTS(000):$1 Customer Comment Form FORMS: NA-14045 OMB NO: 3095-0012 EXPIRATION DATE: 10/31/2002 RESPS:25 HOURS:37 COSTS(000):$0 Application for Attendance at the Institute for the Editing of Historical Documents FORMS: NONE OMB NO: 3095-0013 EXPIRATION DATE: 10/31/2002 RESPS:134 HOURS:7,636 COSTS(000):$0 National Historical Publications and Records Commission Grant Program FORMS: NONE OMB NO: 3095-0014 EXPIRATION DATE: 10/31/2002 RESPS:9 HOURS:72 COSTS(000):$0 Application for Archival Administration or Historical Documentary Editing Fellowships FORMS: NONE OMB NO: 3095-0015 EXPIRATION DATE: 10/31/2002 RESPS:9 HOURS:153 COSTS(000):$0 Application for Host Institutions of Archival Administration or Historical Documentary Editing Fellowships FORMS: NONE OMB NO: 3095-0016 EXPIRATION DATE: 12/31/2001 RESPS:21,876 HOURS:1,823 COSTS(000):$0 Researcher Application FORMS: NA-14003 NA-14003A OMB NO: 3095-0017 EXPIRATION DATE: 05/31/2003 RESPS:1 HOURS:50 COSTS(000):$0 Request to Microfilm Records FORMS: NONE OMB NO: 3095-0021 EXPIRATION DATE: 01/31/2001 RESPS:36 HOURS:135 COSTS(000):$3 National Historical Publications and Records Commission (NHPRC) Subvention Grant Guidelines and Application FORMS: NONE OMB NO: 3095-0022 EXPIRATION DATE: 01/31/2001 RESPS:36 HOURS:36 COSTS(000):$0 National Historical Publications and Records Commission (NHPRC) Annual Sales Report for Subvention Grants FORMS: NONE OMB NO: 3095-0023 EXPIRATION DATE: 03/31/2003 RESPS:6,400 HOURS:533 COSTS(000):$0 NARA Class Evaluation Form FORMS: NA-2019 OMB NO: 3095-0024 EXPIRATION DATE: 08/31/2001 RESPS:1,000 HOURS:334 COSTS(000):$20 Application and Permit for Use of Space in Presidential Library and Grounds FORMS: NA-16011 OMB NO: 3095-0025 EXPIRATION DATE: 06/30/2001 RESPS:1,750 HOURS:438 COSTS(000):$17 Item Approval Request List FORMS: 14110 14110A OMB NO: 3095-0026 EXPIRATION DATE: 08/31/2001 RESPS:1,266 HOURS:64 COSTS(000):$7 Request for and Record of Pass FORMS: NA-6006 OMB NO: 3095-0027 EXPIRATION DATE: 10/31/2001 RESPS:12,000 HOURS:2,000 COSTS(000):$0 National Archives Order for Copies of Ship Passenger Arrival Records; National Archives Order for Copies of Federal Population Census Schedules; National Archives Order for Copies of Eastern.. FORMS: NATF-81 NATF-82 NATF-83 OMB NO: 3095-0029 EXPIRATION DATE: 07/31/2002 RESPS:850,100 HOURS:172,300 COSTS(000):$0 Request Pertaining to Military Records FORMS: SF-180 OMB NO: 3095-0032 EXPIRATION DATE: 12/31/2001 RESPS:150,000 HOURS:17,500 COSTS(000):$0 National Archives Order for Copies of Pension and Bounty Land Warrant Application Files, National Archives Order for Copies of Military Service Records Pre-WWI (Pre-1917) FORMS: NATF-85 NATF-86 OMB NO: 3095-0033 EXPIRATION DATE: 04/30/2003 RESPS:10,000 HOURS:1,667 COSTS(000):$0 National Archives Order for Land Entry Files FORMS: NATF-84 OMB NO: 3095-0035 EXPIRATION DATE: 09/30/2001 RESPS:1 HOURS:15 COSTS(000):$1 Request to Use Personal Paper-to-Paper Copiers at the National Archives at the College Park Facility FORMS: NONE OMB NO: 3095-0036 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:31 COSTS(000):$1 Presidential Library Facilities FORMS: NONE OMB NO: 3095-0037 EXPIRATION DATE: 08/31/2002 RESPS:4,500 HOURS:375 COSTS(000):$0 Returned request Form, Reply to Request Involving Relief FORMS: NA-13022 NA-13064 NA-13068 OMB NO: 3095-0038 EXPIRATION DATE: 12/31/2002 RESPS:5,000 HOURS:1,250 COSTS(000):$0 Court Order Requirements FORMS: NA-FORM-13027 OMB NO: 3095-0039 EXPIRATION DATE: 12/31/2002 RESPS:79,800 HOURS:6,650 COSTS(000):$0 Authorization for Release of Military Medical Patient Records, Request for Information Needed to Locate Medical Records, Request for Information Needed to Reconstruct Medical Data, Questionnaire FORMS: NA-FORMS-13036 13042 13055 13075 OMB NO: 3095-0040 EXPIRATION DATE: 05/31/2003 RESPS:660 HOURS:110 COSTS(000):$0 Request to film, photograph, or videotape at a NARA facility for news purposes FORMS: NONE OMB NO: 3095-0042 EXPIRATION DATE: 08/31/2003 RESPS:4,000 HOURS:667 COSTS(000):$0 Military Personnel Records (MPR) Custmer Satisfaction Survey FORMS: NONE OMB NO: 3095-0043 EXPIRATION DATE: 05/31/2003 RESPS:52 HOURS:52 COSTS(000):$0 Request to use NARA facilities for events FORMS: NA-16008 OMB NO: 3095-0045 EXPIRATION DATE: 10/31/2003 RESPS:13,300 HOURS:1,108 COSTS(000):$0 Applicant Background Survey FORMS: NA-3035
(RETURN TO AGENCY LIST)No active collections for this agency No active collections for this agency OMB NO: 3130-0004 EXPIRATION DATE: 06/30/2001 RESPS:1,000 HOURS:500 COSTS(000):$0 U.S. Participation in International Library and Information Activities FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency OMB NO: 3137-0029 EXPIRATION DATE: 12/31/2003 RESPS:2,664 HOURS:36,432 COSTS(000):$0 Generic Clearance Grant Application Guidelines, Instructions and Reporting Forms FORMS: NONE OMB NO: 3137-0036 EXPIRATION DATE: 04/30/2001 RESPS:278 HOURS:1,406 COSTS(000):$0 1998 Indian Library Services Application and Guidelines FORMS: NONE OMB NO: 3137-0037 EXPIRATION DATE: 12/31/2001 RESPS:1 HOURS:118 COSTS(000):$0 State Grants Annual Report FORMS: NONE OMB NO: 3137-0038 EXPIRATION DATE: 03/31/2002 RESPS:280 HOURS:32 COSTS(000):$0 Museum/Library Partnerships Research FORMS: NONE OMB NO: 3137-0039 EXPIRATION DATE: 04/30/2002 RESPS:3,674 HOURS:1,225 COSTS(000):$0 Conservation Assessment Program (CAP) Evaluation FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3135-0094 EXPIRATION DATE: 09/30/2001 RESPS:40 HOURS:1,800 COSTS(000):$0 Application for Indemnification FORMS: NONE OMB NO: 3135-0098 EXPIRATION DATE: 08/31/2003 RESPS:271 HOURS:54 COSTS(000):$0 National Endowment for the Arts Panelist Profile Form FORMS: NONE OMB NO: 3135-0112 EXPIRATION DATE: 07/31/2003 RESPS:4,805 HOURS:120,407 COSTS(000):$0 FY 2001 - FY 2004 Blanket Justification for NEA Funding Application Guidelines and Reporting Requirements FORMS: NONE OMB NO: 3135-0114 EXPIRATION DATE: 02/28/2001 RESPS:600 HOURS:240 COSTS(000):$0 Customer Service Surveys and Focus Groups FORMS: NONE OMB NO: 3135-0116 EXPIRATION DATE: 05/31/2003 RESPS:1,062 HOURS:2,124 COSTS(000):$0 Civil Rights Compliance and Section 504 Accessibility Checklists FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3136-0134 EXPIRATION DATE: 06/30/2003 RESPS:20,569 HOURS:91,301 COSTS(000):$3,378 Generic Clearance Authority for the National Endowment for the Humanities FORMS: NONE OMB NO: 3136-0136 EXPIRATION DATE: 12/31/2002 RESPS:100,000 HOURS:100,000 COSTS(000):$0 My History is America's History Website FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3140-0001 EXPIRATION DATE: 08/31/2002 RESPS:68 HOURS:31 COSTS(000):$0 Application for Investigation of Representation Dispute FORMS: NMB-1 OMB NO: 3140-0002 EXPIRATION DATE: 08/31/2002 RESPS:123 HOURS:17 COSTS(000):$0 Application for Mediation Services FORMS: NMB-2
(RETURN TO AGENCY LIST)OMB NO: 3145-0019 EXPIRATION DATE: 05/31/2003 RESPS:42,683 HOURS:14,228 COSTS(000):$0 Survey of Earned Doctorates FORMS: NONE OMB NO: 3145-0020 EXPIRATION DATE: 04/30/2001 RESPS:34,000 HOURS:14,167 COSTS(000):$0 1999 Survey of Doctorate Recipients (SDR) FORMS: NONE OMB NO: 3145-0023 EXPIRATION DATE: 09/30/2002 RESPS:13,000 HOURS:156,000 COSTS(000):$0 Fellowship Applications and Award Forms FORMS: NONE OMB NO: 3145-0027 EXPIRATION DATE: 12/31/2001 RESPS:23,400 HOURS:43,000 COSTS(000):$0 Survey of Industrial Research and Development, 1998-2000 FORMS: RD-1 RD-1A OMB NO: 3145-0034 EXPIRATION DATE: 08/31/2001 RESPS:20 HOURS:10 COSTS(000):$0 Antarctic Conservation Act Application Permit Form FORMS: NSF-1078 OMB NO: 3145-0035 EXPIRATION DATE: 08/31/2002 RESPS:137 HOURS:1,242 COSTS(000):$0 National Science Foundation Science Honor Awards FORMS: NSF-1122 NSF-1123 NSF-1124 OMB NO: 3145-0058 EXPIRATION DATE: 07/31/2003 RESPS:30,000 HOURS:3,600,000 COSTS(000):$0 National Science Foundation Proposal/Award Information -- Grant Proposal Guide FORMS: NONE OMB NO: 3145-0060 EXPIRATION DATE: 03/31/2002 RESPS:157,700 HOURS:753,500 COSTS(000):$0 National Science Foundation Proposal Review Process FORMS: NSFFORM1 NSFFORM428 OMB NO: 3145-0062 EXPIRATION DATE: 09/30/2002 RESPS:11,385 HOURS:23,690 COSTS(000):$0 Survey of Graduate Students and Postdoctorates in Science and Engineering FORMS: NSF-811 NSF-812 OMB NO: 3145-0077 EXPIRATION DATE: 02/28/2002 RESPS:24,975 HOURS:12,487 COSTS(000):$0 1999 National Survey of Recent College Graduates (NSRCG:99) FORMS: NONE OMB NO: 3145-0080 EXPIRATION DATE: 07/31/2003 RESPS:270 HOURS:56,010 COSTS(000):$0 Request for Proposals FORMS: NONE OMB NO: 3145-0096 EXPIRATION DATE: 08/31/2002 RESPS:2,000 HOURS:100 COSTS(000):$0 Applicant Survey FORMS: 1232 OMB NO: 3145-0100 EXPIRATION DATE: 04/30/2002 RESPS:698 HOURS:9,014 COSTS(000):$0 Survey of Research and Development Expenditures at Universities and Colleges, FY 1999 through FY 2001 FORMS: NSF-411 OMB NO: 3145-0101 EXPIRATION DATE: 08/31/2002 RESPS:976 HOURS:1,302 COSTS(000):$0 National Survey of Scientific and Engineering Research FORMS: NONE OMB NO: 3145-0136 EXPIRATION DATE: 09/30/2001 RESPS:37,772 HOURS:38,437 COSTS(000):$790 Computer Science, Engineering and Mathematics Scholarship FORMS: NONE OMB NO: 3145-0141 EXPIRATION DATE: 04/30/2001 RESPS:37,600 HOURS:15,666 COSTS(000):$0 1999 National Survey of College Graduates (NSCG) FORMS: NONE OMB NO: 3145-0153 EXPIRATION DATE: 04/30/2002 RESPS:580 HOURS:232 COSTS(000):$0 Outcomes and Impacts of the State/Industry University Cooperative Research Centers (S/IUCRC) Program FORMS: NONE OMB NO: 3145-0157 EXPIRATION DATE: 09/30/2002 RESPS:50,280 HOURS:4,213 COSTS(000):$0 NSF Surveys to Measure Customer Service Satisfaction (FastLane FORMS: NONE OMB NO: 3145-0167 EXPIRATION DATE: 02/28/2003 RESPS:255 HOURS:540 COSTS(000):$205 An Evaluation of FY 1989-90 Awards made under the National Science Foundation's Design and Manufacturing Research Programs FORMS: NONE OMB NO: 3145-0174 EXPIRATION DATE: 12/31/2003 RESPS:1,620 HOURS:6,240 COSTS(000):$0 Generic Survey Clearance of the Science Resources Studies Survey Improvement Projects and Quick Response Studies FORMS: NONE OMB NO: 3145-0175 EXPIRATION DATE: 11/30/2003 RESPS:1,040 HOURS:780 COSTS(000):$0 Evaluation of the NSF Summer Programs in Japan; NSF postdoctoral Fellowships in Japan; and the NSF-CGP Fellowship Program. FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency No active collections for this agency No active collections for this agency OMB NO: 3209-0001 EXPIRATION DATE: 03/31/2003 RESPS:260 HOURS:780 COSTS(000):$0 Executive Branch Personnel Public Financial Disclosure Report FORMS: 278 OMB NO: 3209-0002 EXPIRATION DATE: 07/31/2002 RESPS:172 HOURS:29 COSTS(000):$0 Request to Inspect or Receive Copies of SF-278 Executive Branch Personnel Public Financial Disclosure Report or Other Covered Record FORMS: 201 OMB NO: 3209-0006 EXPIRATION DATE: 04/30/2002 RESPS:10 HOURS:15 COSTS(000):$0 Executive Branch Confidential Financial Disclosure Report FORMS: OGE-450 OMB NO: 3209-0007 EXPIRATION DATE: 10/31/2001 RESPS:294 HOURS:3,785 COSTS(000):$0 Executive Branch Qualified Trust Documents (See Item Nos. 1-2 of the Supporting Statement for Precise Title of All Documents) FORMS: NONE OMB NO: 3209-0009 EXPIRATION DATE: 10/31/2001 RESPS:186 HOURS:9 COSTS(000):$0 Public Financial Disclosure Access Customer Service Survey FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 0348-0002 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Outlay Report and Request for Reimbursement for Construction Programs -- SF-271 FORMS: SF-271 OMB NO: 0348-0003 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Federal Cash Transactions Report -- SF-272 and 272A FORMS: SF-272 SF-272A OMB NO: 0348-0004 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Request for Advance or Reimbursement -- SF-270 FORMS: SF-270 OMB NO: 0348-0038 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Financial Status Report (Short Form) -- SF-269A FORMS: SF-269A OMB NO: 0348-0039 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Financial Status Report (Long Form) -- SF-269 FORMS: SF-269 OMB NO: 0348-0040 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Assurances, Nonconstruction Programs -- SF-424B FORMS: SF-424B OMB NO: 0348-0041 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Budget Information, Construction Program -- SF-424C FORMS: SF-424C OMB NO: 0348-0042 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Assurances, Construction Programs -- SF-424D FORMS: SF-424D OMB NO: 0348-0043 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Application for Federal Assistance -- SF-424 FORMS: SF-424 OMB NO: 0348-0044 EXPIRATION DATE: 11/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Budget Information, Nonconstuction Programs -- SF-424A FORMS: SF-424A OMB NO: 0348-0055 EXPIRATION DATE: 02/28/2001 RESPS:5 HOURS:200 COSTS(000):$8,000 Cost Accounting Standards Board Disclosure Statement for Educational Institutions FORMS: DS-2 OMB NO: 0348-0058 EXPIRATION DATE: 06/30/2003 RESPS:141 HOURS:514 COSTS(000):$0 A-21 Facilities and Administrative Proposal FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency OMB NO: 3206-0001 EXPIRATION DATE: 07/31/2002 RESPS:1 HOURS:450 COSTS(000):$0 Application for 10-Point Veteran Preference FORMS: SF-15 OMB NO: 3206-0005 EXPIRATION DATE: 06/30/2001 RESPS:10 HOURS:5 COSTS(000):$0 Questionnaire for Nonsensitive Positions FORMS: 85 OMB NO: 3206-0006 EXPIRATION DATE: 05/31/2003 RESPS:1,560 HOURS:3,120 COSTS(000):$2 Monthly Report of Federal Civilian Employment FORMS: 113-A OMB NO: 3206-0007 EXPIRATION DATE: 06/30/2001 RESPS:172,150 HOURS:258,225 COSTS(000):$0 Questionnaire for National Security Positions, Continuation Sheet for Questionnaires SF-86, SF-85P, and SF-85 FORMS: 86 86A OMB NO: 3206-0017 EXPIRATION DATE: 09/30/2002 RESPS:1 HOURS:17 COSTS(000):$0 Medicare Part B Certification FORMS: RI-78-11 OMB NO: 3206-0032 EXPIRATION DATE: 08/31/2001 RESPS:14,000 HOURS:2,800 COSTS(000):$0 Self-Certification of Full-Time School Attendance FORMS: RI-25-14 OMB NO: 3206-0033 EXPIRATION DATE: 03/31/2003 RESPS:1,000 HOURS:250 COSTS(000):$0 Marital Status Certification FORMS: RI-25-7 OMB NO: 3206-0034 EXPIRATION DATE: 09/30/2003 RESPS:21,000 HOURS:12,250 COSTS(000):$0 Annuitant's Report of Earned Income FORMS: 30-2 OMB NO: 3206-0036 EXPIRATION DATE: 08/31/2002 RESPS:21,200 HOURS:75,800 COSTS(000):$0 Establishment Information Form, Wage Data Collection Form, Wage Data Collection Continuation Form FORMS: DD-1918 DD-1919 DD-1919C OMB NO: 3206-0040 EXPIRATION DATE: 10/31/2001 RESPS:500,000 HOURS:225,000 COSTS(000):$0 Qualifications and Availability Form FORMS: 1203AW 1203FX OMB NO: 3206-0042 EXPIRATION DATE: 03/31/2003 RESPS:1 HOURS:1,250 COSTS(000):$0 Notice of Change in Student's Status FORMS: RI-25-15 OMB NO: 3206-0061 EXPIRATION DATE: 10/31/2001 RESPS:50 HOURS:13 COSTS(000):$0 Application for Minimum Annuity FORMS: RI-20-I OMB NO: 3206-0082 EXPIRATION DATE: 07/31/2002 RESPS:2,000 HOURS:4,000 COSTS(000):$0 Presidential Management Intern Program Application FORMS: PMI-01 OMB NO: 3206-0095 EXPIRATION DATE: 03/31/2001 RESPS:100,000 HOURS:8,333 COSTS(000):$0 Applicant Race and National Origin Questionnaire FORMS: 1386B OMB NO: 3206-0099 EXPIRATION DATE: 08/31/2003 RESPS:1,200 HOURS:1,800 COSTS(000):$0 Initial Certification of Full-time School Attendance FORMS: RI-25-41 OMB NO: 3206-0121 EXPIRATION DATE: 06/30/2001 RESPS:3,000 HOURS:3,000 COSTS(000):$0 Application for Deferred Retirement (Separations Before October 1, 1956); Application for Deferred Retirement (Separations On or After October 1, 1956) FORMS: OPM-1496 OPM-1496A OMB NO: 3206-0128 EXPIRATION DATE: 06/30/2001 RESPS:32,100 HOURS:31,298 COSTS(000):$0 Application for Refund of Retirement Deductions (CSRS) FORMS: SF-2802 SF-2802B OMB NO: 3206-0130 EXPIRATION DATE: 10/31/2001 RESPS:1,572 HOURS:3,144 COSTS(000):$0 Monthly Report of Full-Time Equivalent/Work-Year Civilian Employment FORMS: SF-113-G OMB NO: 3206-0131 EXPIRATION DATE: 04/30/2001 RESPS:1,400 HOURS:4,200 COSTS(000):$0 Combined Federal Campaign Eligibility Application FORMS: OPM-1647 OMB NO: 3206-0134 EXPIRATION DATE: 05/31/2003 RESPS:150 HOURS:75 COSTS(000):$0 Application to Make Deposit or Redeposit (CSRS) Application to Make Service Credit Payment for Civilian Service (FERS) FORMS: SF-2803 SF-3108 OMB NO: 3206-0136 EXPIRATION DATE: 12/31/2003 RESPS:41,000 HOURS:10,250 COSTS(000):$0 Designation of Beneficiary: Federal Employees' Group Life Insurance Program FORMS: SF-2823 OMB NO: 3206-0138 EXPIRATION DATE: 09/30/2003 RESPS:200 HOURS:200 COSTS(000):$0 Reinstatement of Disability Annuity Previously Terminated Because of Restoration to Earning Capacity FORMS: RI-30-9 OMB NO: 3206-0141 EXPIRATION DATE: 06/30/2002 RESPS:1 HOURS:16,667 COSTS(000):$0 Health Benefits Registration Form FORMS: OPM-2809 OMB NO: 3206-0142 EXPIRATION DATE: 06/30/2001 RESPS:2,000 HOURS:500 COSTS(000):$0 Designation of Beneficiary (CSRS) FORMS: SF-2808 OMB NO: 3206-0143 EXPIRATION DATE: 04/30/2001 RESPS:8,000 HOURS:8,000 COSTS(000):$0 Request to Disability Annuitant for Information on Physical Condition and Employment FORMS: RI-30-1 OMB NO: 3206-0144 EXPIRATION DATE: 09/30/2002 RESPS:1 HOURS:250 COSTS(000):$0 We Need the Social Security Number of the Person Named Below FORMS: RI-38-45 OMB NO: 3206-0150 EXPIRATION DATE: 04/30/2001 RESPS:250,000 HOURS:20,833 COSTS(000):$0 Fingerprint Charts FORMS: SF-87 SF-87A OMB NO: 3206-0156 EXPIRATION DATE: 03/31/2002 RESPS:2 HOURS:56,100 COSTS(000):$0 Application for Death Benefits under the Civil Service Retirement System Documentation and Elections in Support of Application for Death Benefits When the Deceased Was an.... FORMS: 2800 2800A OMB NO: 3206-0158 EXPIRATION DATE: 04/30/2001 RESPS:500 HOURS:375 COSTS(000):$0 Former Spouse's Application for Survivor Annuity under the Civil Service Retirement System FORMS: 1536 OMB NO: 3206-0160 EXPIRATION DATE: 03/31/2002 RESPS:9,000 HOURS:4,500 COSTS(000):$0 Employee Health Benefits Election Form FORMS: SF-2809 OMB NO: 3206-0162 EXPIRATION DATE: 06/30/2001 RESPS:500 HOURS:750 COSTS(000):$0 Report of Medical Examination of Person Electing Survivor Benefits under the Civil Service Retirement System FORMS: 1530 OMB NO: 3206-0165 EXPIRATION DATE: 11/30/2001 RESPS:1,609,000 HOURS:134,083 COSTS(000):$0 Investigative Request for Employment Data and Supervisory Information, Personal Information, Educational Registrar, and Dean of Students Record Data and Law Enforcement Data FORMS: NONE OMB NO: 3206-0167 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:2,081 COSTS(000):$0 Financial Resources Questionnaire Notice of Amount Due Because of Annuity Overpayment FORMS: RI-34-1 RI-34-3 OMB NO: 3206-0168 EXPIRATION DATE: 12/31/2001 RESPS:200 HOURS:67 COSTS(000):$0 Alternative Annuity Election FORMS: RI-20-80 OMB NO: 3206-0170 EXPIRATION DATE: 12/31/2001 RESPS:30,825 HOURS:9,076 COSTS(000):$0 Application for Refund of Retirement Deductions/Federal Employees Retirement System (SF-3106) Current/Former Spouse's Notification of Application for Refund of Retirement Deductions FORMS: SF-3106 SF-3106A OMB NO: 3206-0172 EXPIRATION DATE: 12/31/2003 RESPS:8,061 HOURS:8,061 COSTS(000):$0 Application for Death Benefits/Federal Employees' Retirement System Documentation and Elections in Support of Application for Death Benefits when Deceased was an Employee at the Time of Death FORMS: SF-3104 SF-3104B OMB NO: 3206-0173 EXPIRATION DATE: 09/30/2002 RESPS:1,273 HOURS:318 COSTS(000):$0 Designation of Beneficiary (FERC) FORMS: 3102 OMB NO: 3206-0174 EXPIRATION DATE: 05/31/2003 RESPS:2,400 HOURS:1,834 COSTS(000):$0 Survivor Annuity Election for a Spouse/Cover Letter for RI 20-63 Giving Information About the Cost to elect Less Than the Maximum Survivor Annuity/Cover Letter for RI 20-63 Giving Information.... FORMS: RI-20-63 RI-20-116 RI-20-117 OMB NO: 3206-0179 EXPIRATION DATE: 06/30/2001 RESPS:2,500 HOURS:2,500 COSTS(000):$250 Disabled Dependent Questionnaire FORMS: RI-30-10 OMB NO: 3206-0182 EXPIRATION DATE: 09/30/2003 RESPS:435,000 HOURS:108,750 COSTS(000):$0 Declaration for Federal Employment, Optional Form 306 FORMS: NONE OMB NO: 3206-0187 EXPIRATION DATE: 04/30/2001 RESPS:8,000 HOURS:1,350 COSTS(000):$0 We Need More Information About Your Missing Payment FORMS: RI-38-31 OMB NO: 3206-0190 EXPIRATION DATE: 08/31/2003 RESPS:1,272 HOURS:1,272 COSTS(000):$0 Application for Deferred or Postponed Retirement (FERS) FORMS: RI-92-19 RI-92-19A OMB NO: 3206-0191 EXPIRATION DATE: 06/30/2001 RESPS:1,500 HOURS:1,500 COSTS(000):$0 Questionnaire for Public Trust Positions and Supplemental Questionnaire for Selected Positions FORMS: 85P 85P-S OMB NO: 3206-0194 EXPIRATION DATE: 09/30/2003 RESPS:180 HOURS:45 COSTS(000):$0 Annuity Supplement Earnings Report FORMS: RI-92-22 OMB NO: 3206-0197 EXPIRATION DATE: 05/31/2003 RESPS:25,400 HOURS:4,234 COSTS(000):$0 Verification of Who Is Getting Payments FORMS: 38-107 OMB NO: 3206-0199 EXPIRATION DATE: 08/31/2001 RESPS:4,000 HOURS:480 COSTS(000):$0 Nonforeign Area COLA Price and Background Surveys FORMS: NONE OMB NO: 3206-0201 EXPIRATION DATE: 01/31/2001 RESPS:1 HOURS:18,267 COSTS(000):$0 Federal Employees Health Benefits Open Season Express, Interactive Voice Response System FORMS: NONE OMB NO: 3206-0204 EXPIRATION DATE: 09/30/2001 RESPS:19,000 HOURS:9,500 COSTS(000):$0 Court Orders Affecting Retirement Benefits -- 5 CFR Sections 838.221, 838.421, and 838.721 FORMS: NONE OMB NO: 3206-0206 EXPIRATION DATE: 08/31/2001 RESPS:250 HOURS:250 COSTS(000):$0 Evidence to Prove Dependency of a Child FORMS: RI-25-37 OMB NO: 3206-0208 EXPIRATION DATE: 04/30/2001 RESPS:4,067 HOURS:1,356 COSTS(000):$0 Representative Payee Survey FORMS: RI-38-115 OMB NO: 3206-0211 EXPIRATION DATE: 12/31/2003 RESPS:3,000 HOURS:350 COSTS(000):$0 Reemployment of Annuitants - 5 CFR Section 837.103 FORMS: NONE OMB NO: 3206-0212 EXPIRATION DATE: 01/31/2001 RESPS:1 HOURS:3,000 COSTS(000):$0 Rollover Election FORMS: RI-38-117 RI-38-118 RI-37-22 OMB NO: 3206-0213 EXPIRATION DATE: 02/28/2001 RESPS:100 HOURS:50 COSTS(000):$0 Marital Information Required of Refund Applicants FORMS: RI95-4 OMB NO: 3206-0215 EXPIRATION DATE: 09/30/2002 RESPS:1 HOURS:10,000 COSTS(000):$0 Verification of Full-Time School Attendance FORMS: RI-25-49 OMB NO: 3206-0216 EXPIRATION DATE: 04/30/2001 RESPS:2,200 HOURS:183 COSTS(000):$0 We Need Important Information About Your Eligibility for SSA Disability Benefits (Our Records Show That You Have Not Received A Decision From The SSA.) FORMS: RI-98-7 OMB NO: 3206-0218 EXPIRATION DATE: 04/30/2001 RESPS:700 HOURS:700 COSTS(000):$19,400 Death Benefit Payment Rollover Election Form FORMS: RI-94-7 OMB NO: 3206-0224 EXPIRATION DATE: 05/31/2001 RESPS:245,000 HOURS:4,083 COSTS(000):$0 Federal Employment Information Customer Survey FORMS: OPM-1593 OMB NO: 3206-0226 EXPIRATION DATE: 12/31/2003 RESPS:45,500 HOURS:22,750 COSTS(000):$0 It's Time to Sign Up for Direct Deposit FORMS: RI-38-128 OMB NO: 3206-0228 EXPIRATION DATE: 12/31/2003 RESPS:12,775 HOURS:12,775 COSTS(000):$0 CSRS/FERS Documentation in Support of Disability Retirement Application FORMS: SF-3112 OMB NO: 3206-0230 EXPIRATION DATE: 05/31/2003 RESPS:100 HOURS:25 COSTS(000):$0 Life Insurance Election FORMS: SF-2817 OMB NO: 3206-0231 EXPIRATION DATE: 01/31/2001 RESPS:10,000 HOURS:20,000 COSTS(000):$500,000 Federal Contractor Welfare-to-Work Success Stories FORMS: NONE OMB NO: 3206-0233 EXPIRATION DATE: 06/30/2001 RESPS:22,000 HOURS:11,000 COSTS(000):$0 Civil Service Retirement System Survivor Annuitant Express Pay Application for Death Benefits FORMS: RI-25-51 OMB NO: 3206-0234 EXPIRATION DATE: 08/31/2001 RESPS:3,300 HOURS:1,650 COSTS(000):$0 Claim for Unpaid Compensation of Deceased Civilian Employee FORMS: SF-1153 OMB NO: 3206-0235 EXPIRATION DATE: 08/31/2001 RESPS:30 HOURS:23 COSTS(000):$0 Former Spouse Survivor Annuity Election, Information on Electing a Survivor Annuity for Your Former Spouse FORMS: RI-20-64 RI-20-64A OMB NO: 3206-0236 EXPIRATION DATE: 10/31/2001 RESPS:7,333,355 HOURS:118,000 COSTS(000):$0 Generic Clearance Package for FY 1998, 1999, 2000 FORMS: NONE OMB NO: 3206-0237 EXPIRATION DATE: 11/30/2001 RESPS:3,100 HOURS:2,325 COSTS(000):$0 Information and Instructions on Your Reconsideration Rights FORMS: RI-38-47 OMB NO: 3206-0239 EXPIRATION DATE: 03/31/2002 RESPS:9,000 HOURS:4,500 COSTS(000):$0 Annuitant/OWCP Health Benefits Election Form FORMS: 2809-1 OMB NO: 3206-0241 EXPIRATION DATE: 02/28/2001 RESPS:900 HOURS:15 COSTS(000):$0 Customer Satisfaction Survey of Workforce Compensation & Performance Service web pages FORMS: NONE OMB NO: 3206-0242 EXPIRATION DATE: 04/30/2001 RESPS:1,560,000 HOURS:156,000 COSTS(000):$0 We're Listening - A Survey of the OHRD Website FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3255-0002 EXPIRATION DATE: 08/31/2003 RESPS:2,246 HOURS:2,689 COSTS(000):$0 (a) Complaint of Possible Prohibited Personnel Practice or Other Prohibited Activity; (b) Disclosure of Information FORMS: OSC-11 OSC-12 OMB NO: 3255-0003 EXPIRATION DATE: 03/31/2002 RESPS:6,820 HOURS:1,633 COSTS(000):$0 OSC Customer Survey Forms FORMS: 48A 48B 48C
(RETURN TO AGENCY LIST)OMB NO: 0349-0002 EXPIRATION DATE: 11/30/2002 RESPS:120 HOURS:60 COSTS(000):$0 OSTP Evaluation of Performance as Required under the Government Performance and Results Act (GPRA) FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency OMB NO: 3420-0001 EXPIRATION DATE: 09/30/2001 RESPS:850 HOURS:708 COSTS(000):$0 Request for Registration for Political Risk Investment Insurance -- OPIC-50 FORMS: OPIC-50 OMB NO: 3420-0004 EXPIRATION DATE: 09/30/2001 RESPS:25 HOURS:175 COSTS(000):$0 Project Information Report FORMS: OPIC-71 OMB NO: 3420-0007 EXPIRATION DATE: 01/31/2001 RESPS:15 HOURS:60 COSTS(000):$0 Contractors and Exporters Program: Application for Political Risk Investment Insurance FORMS: OPIC-81 OMB NO: 3420-0011 EXPIRATION DATE: 06/30/2003 RESPS:160 HOURS:960 COSTS(000):$0 Application for Political Risk Investment Insurance FORMS: OPIC-52 OMB NO: 3420-0015 EXPIRATION DATE: 10/31/2001 RESPS:300 HOURS:900 COSTS(000):$0 Finance Application FORMS: 115 OMB NO: 3420-0018 EXPIRATION DATE: 03/31/2003 RESPS:123 HOURS:735 COSTS(000):$0 Sponsor Disclosure Report in Support of an Application for Financing FORMS: OPIC-129 OMB NO: 3420-0019 EXPIRATION DATE: 07/31/2003 RESPS:200 HOURS:600 COSTS(000):$0 Self-Monitoring Questionnaire for Insurance and Finance Projects FORMS: OPIC162 OMB NO: 3420-0020 EXPIRATION DATE: 08/31/2003 RESPS:30 HOURS:30 COSTS(000):$0 Expedited Screening Questionnaire -- Downstream Investments FORMS: OPIC-168 OMB NO: 3420-0022 EXPIRATION DATE: 08/31/2003 RESPS:50 HOURS:200 COSTS(000):$0 Small Business Application for Political Risk Investment Insurance FORMS: OPIC-223 OMB NO: 3420-0023 EXPIRATION DATE: 07/31/2003 RESPS:190 HOURS:570 COSTS(000):$0 Self Monitoring Questionnaire for Investment Funds Projects FORMS: OPIC-217 OMB NO: 3420-0027 EXPIRATION DATE: 02/28/2001 RESPS:126 HOURS:63 COSTS(000):$0 OPIC Survey of Client Satisfaction FORMS: OPIC-232
(RETURN TO AGENCY LIST)OMB NO: 3207-0005 EXPIRATION DATE: 02/28/2001 RESPS:7,453 HOURS:9,082 COSTS(000):$0 Personnel Administration Forms FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 0420-0001 EXPIRATION DATE: 08/31/2003 RESPS:1 HOURS:2,500 COSTS(000):$27,062 National Agency Check Questionnaire for Peace Corps Volunteer Background Investigation FORMS: PC-5 OMB NO: 0420-0005 EXPIRATION DATE: 12/31/2001 RESPS:30,000 HOURS:240,000 COSTS(000):$0 Peace Corps Volunteer Application FORMS: PC-1502 OMB NO: 0420-0006 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:13,692 COSTS(000):$0 Peace Corps Reference Form FORMS: RMB-27 OMB NO: 0420-0007 EXPIRATION DATE: 12/31/2001 RESPS:35,000 HOURS:1,021 COSTS(000):$0 Request for Information Card FORMS: PC-1741 OMB NO: 0420-0510 EXPIRATION DATE: 01/31/2001 RESPS:1 HOURS:1,625 COSTS(000):$616 Health Status Review/Report of Medical Exam FORMS: 1789 1790 OMB NO: 0420-0513 EXPIRATION DATE: 04/30/2002 RESPS:10,000 HOURS:833 COSTS(000):$0 Teacher Brochure/Enrollment Form FORMS: NONE OMB NO: 0420-0529 EXPIRATION DATE: 12/31/2001 RESPS:1 HOURS:6,500 COSTS(000):$0 Peace Corps Day Brochure FORMS: WWSD-BRO99 OMB NO: 0420-0531 EXPIRATION DATE: 12/31/2001 RESPS:3,000 HOURS:150 COSTS(000):$0 Career Information Consultants Waiver Form FORMS: NONE OMB NO: 0420-0532 EXPIRATION DATE: 05/31/2002 RESPS:10,000 HOURS:833 COSTS(000):$0 Educator Technology Information Form FORMS: NONE OMB NO: 0420-0533 EXPIRATION DATE: 08/31/2003 RESPS:1,000 HOURS:83 COSTS(000):$0 Peace Corps - Crisis Corps Application FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 1212-0009 EXPIRATION DATE: 12/31/2003 RESPS:47,600 HOURS:2,482 COSTS(000):$9,431 Payment of Premiums (29 CFR Part 4007), Disclosure to Participants (29 CFR Part 4011) FORMS: FORM-1-SCHE.A FORM-1-ES OMB NO: 1212-0013 EXPIRATION DATE: 11/30/2002 RESPS:305 HOURS:1,249 COSTS(000):$187 Reportable Events FORMS: 10 10-ADVANCE OMB NO: 1212-0017 EXPIRATION DATE: 10/31/2001 RESPS:13 HOURS:156 COSTS(000):$23 Liability for Termination of Single-Employer Plans FORMS: NONE OMB NO: 1212-0020 EXPIRATION DATE: 10/31/2001 RESPS:3,021 HOURS:48 COSTS(000):$13 Termination of Multiemployer Plans -- 29 CFR Part 4041A FORMS: NONE OMB NO: 1212-0021 EXPIRATION DATE: 10/31/2001 RESPS:24 HOURS:1 COSTS(000):$2 Variances for Sale of Assets -- 29 CFR Part 4204 FORMS: NONE OMB NO: 1212-0022 EXPIRATION DATE: 10/31/2001 RESPS:20 HOURS:5 COSTS(000):$2 Mergers and Transfers Between Multiemployer Plans -- 29 CFR Part 4231 FORMS: NONE OMB NO: 1212-0023 EXPIRATION DATE: 10/31/2001 RESPS:1 HOURS:1 COSTS(000):$2 Extension of Special Withdrawal Liability Rules -- 29 CFR Part 4203 FORMS: NONE OMB NO: 1212-0026 EXPIRATION DATE: 11/30/2001 RESPS:45,000 HOURS:5,639 COSTS(000):$3,062 Annual Information Return/Report FORMS: 5500 OMB NO: 1212-0030 EXPIRATION DATE: 01/31/2003 RESPS:32 HOURS:32 COSTS(000):$0 Survey of Nonparticipating Single-Premium Group Annuity Rates FORMS: NONE OMB NO: 1212-0031 EXPIRATION DATE: 10/31/2001 RESPS:3 HOURS:1 COSTS(000):$0 Procedures for PBGC Approval of Plan Amendments -- 29 CFR Part FORMS: NONE OMB NO: 1212-0032 EXPIRATION DATE: 10/31/2001 RESPS:20,943 HOURS:1 COSTS(000):$83 Duties of Plan Sponsor Following Mass Withdrawal -- 29 CFR Part 4281 FORMS: NONE OMB NO: 1212-0033 EXPIRATION DATE: 10/31/2001 RESPS:8,018 HOURS:1 COSTS(000):$10 Notice of Insolvency -- 29 CFR Part 4245 FORMS: NONE OMB NO: 1212-0034 EXPIRATION DATE: 10/31/2001 RESPS:179 HOURS:4 COSTS(000):$3 Notice, Collection, and Redetermination of Withdrawal Liability -- 29 CFR Part 4219 FORMS: NONE OMB NO: 1212-0035 EXPIRATION DATE: 10/31/2001 RESPS:5 HOURS:10 COSTS(000):$0 Allocating Unfunded Vested Benefits -- 29 CFR Part 4211 FORMS: NONE OMB NO: 1212-0036 EXPIRATION DATE: 03/31/2001 RESPS:3,790 HOURS:5,231 COSTS(000):$2,762 Termination of Single Employer Plans FORMS: 500 501 600 601 602 EA-S REP-S REP-D EA-D MP OMB NO: 1212-0039 EXPIRATION DATE: 10/31/2001 RESPS:2,001 HOURS:250.5 COSTS(000):$150 Reduction or Waiver of Partial Withdrawal Liability -- 29 CFR Part 4208 FORMS: NONE OMB NO: 1212-0041 EXPIRATION DATE: 10/31/2002 RESPS:25 HOURS:42 COSTS(000):$6 Notice of Failure to Make Required Contributions FORMS: 200 OMB NO: 1212-0044 EXPIRATION DATE: 10/31/2001 RESPS:201 HOURS:25.5 COSTS(000):$15 Reduction or Waiver of Complete Withdrawal Liability -- 29 CFR Part 4207 FORMS: NONE OMB NO: 1212-0049 EXPIRATION DATE: 12/31/2001 RESPS:60 HOURS:552 COSTS(000):$450 Annual Finanical and Actuarial Information Reporting -- 29 CFR Part 4010 FORMS: NONE OMB NO: 1212-0050 EXPIRATION DATE: 10/31/2001 RESPS:3,500 HOURS:6,904 COSTS(000):$259 Disclosure to Participants FORMS: NONE OMB NO: 1212-0053 EXPIRATION DATE: 06/30/2003 RESPS:9,500 HOURS:2,500 COSTS(000):$0 Customer Service Focus Groups and Surveys FORMS: NONE OMB NO: 1212-0054 EXPIRATION DATE: 08/31/2003 RESPS:300 HOURS:104 COSTS(000):$119 Qualified Domestic Relations Orders Submitted to the PBGC FORMS: NONE OMB NO: 1212-0055 EXPIRATION DATE: 11/30/2002 RESPS:76,750 HOURS:32,125 COSTS(000):$25 Locating and Paying Participants FORMS: NONE OMB NO: 1212-0057 EXPIRATION DATE: 08/31/2001 RESPS:47,000 HOURS:1 COSTS(000):$0 Annual Information Return/Report FORMS: 5500
(RETURN TO AGENCY LIST)No active collections for this agency No active collections for this agency OMB NO: 3220-0002 EXPIRATION DATE: 04/30/2001 RESPS:19,225 HOURS:11,637 COSTS(000):$0 Application for Employee Annuity under the Railroad Retirement Act FORMS: AA-1 AA-1D G-204 OMB NO: 3220-0005 EXPIRATION DATE: 11/30/2003 RESPS:4,300 HOURS:379 COSTS(000):$0 Employer Reporting FORMS: AA-12 G-88A.1 G-88A.2 OMB NO: 3220-0007 EXPIRATION DATE: 09/30/2001 RESPS:1,350 HOURS:449 COSTS(000):$0 Appeal under the Railroad Retirement and Railroad Unemployment Insurance Act FORMS: HA-1 OMB NO: 3220-0008 EXPIRATION DATE: 09/30/2001 RESPS:1,159 HOURS:50,893 COSTS(000):$0 Railroad Service and Compensation Reports FORMS: BA-3A BA-4 OMB NO: 3220-0012 EXPIRATION DATE: 02/28/2003 RESPS:2,200 HOURS:917 COSTS(000):$0 Employer's Quarterly Report of Contribution Under the RUIA FORMS: DC-1 OMB NO: 3220-0014 EXPIRATION DATE: 07/31/2003 RESPS:65 HOURS:33 COSTS(000):$0 Employee Representatives' Status and Compensation Reports FORMS: DC-2A DC-2 OMB NO: 3220-0016 EXPIRATION DATE: 05/31/2002 RESPS:3,600 HOURS:360 COSTS(000):$0 Certification of Relinquishment of Rights FORMS: G-88 OMB NO: 3220-0021 EXPIRATION DATE: 01/31/2003 RESPS:1,100 HOURS:196 COSTS(000):$0 Evidence of Marital Relationship; Living with Requirements FORMS: G-124 G-124A G-237 G-238 G-238A OMB NO: 3220-0022 EXPIRATION DATE: 06/30/2003 RESPS:78,700 HOURS:8,617 COSTS(000):$0 Application and Claim for Unemployment Benefits and Employment Service FORMS: UI-1 UI-3 OMB NO: 3220-0025 EXPIRATION DATE: 11/30/2003 RESPS:7,905 HOURS:1,622 COSTS(000):$0 RUIA Investigations and Continuing Entitlement FORMS: UI-9 UI-23 ID-4F ID-4U ID-4X ID-4Y ID-20-1 ID-20-2 ID-20-4 ID-5I......... OMB NO: 3220-0030 EXPIRATION DATE: 09/30/2001 RESPS:5,765 HOURS:2,864 COSTS(000):$0 Application for Survivor Insurance Annuities FORMS: AA-17 AA-17B AA-18 AA-19 AA-19A AA-20 OMB NO: 3220-0031 EXPIRATION DATE: 01/31/2003 RESPS:20,600 HOURS:5,150 COSTS(000):$0 Application for Survivor Death Benefits FORMS: AA-21 G-273A AA-11A G-131 AA-21CERT OMB NO: 3220-0032 EXPIRATION DATE: 06/30/2003 RESPS:8,000 HOURS:1,391 COSTS(000):$0 Survivor Questionnaire FORMS: RL-94-F OMB NO: 3220-0034 EXPIRATION DATE: 11/30/2002 RESPS:400 HOURS:40 COSTS(000):$0 Statement of Authority To Act for Employee FORMS: SI-10 OMB NO: 3220-0036 EXPIRATION DATE: 01/31/2002 RESPS:30,700 HOURS:1,875 COSTS(000):$0 Supplemental Information on Accident and Insurance FORMS: SI-1C SI-5 ID-3S ID-3S-1 ID-3U ID-30K ID-30K-1 OMB NO: 3220-0038 EXPIRATION DATE: 10/31/2002 RESPS:29,950 HOURS:12,417 COSTS(000):$0 Medical Reports FORMS: G-3EMP G-250 G-250A G-260 RL-11B RL-11D OMB NO: 3220-0039 EXPIRATION DATE: 04/30/2001 RESPS:270,900 HOURS:27,921 COSTS(000):$0 Application and Claim for Sickness Benefits FORMS: SI-1A SI-1B SI-3 SI-7 SI-8 ID-7H ID-11A OMB NO: 3220-0042 EXPIRATION DATE: 06/30/2003 RESPS:8,500 HOURS:4,714 COSTS(000):$0 Application for Spouse Annuity Under the Railroad Retirement Act FORMS: AA-3 OMB NO: 3220-0052 EXPIRATION DATE: 03/31/2001 RESPS:20,300 HOURS:16,350 COSTS(000):$0 Application to Act as Representative Payee FORMS: AA-5 G-478 OMB NO: 3220-0055 EXPIRATION DATE: 02/28/2003 RESPS:200 HOURS:23 COSTS(000):$0 Application and Claim for RUIA Benefits Due at Death FORMS: UI-63 OMB NO: 3220-0057 EXPIRATION DATE: 06/30/2001 RESPS:27,000 HOURS:1,494 COSTS(000):$0 Placement Service FORMS: ES-2 ES-20A ES-20B ES-21 ES-21C UI-35 OMB NO: 3220-0070 EXPIRATION DATE: 09/30/2001 RESPS:4,500 HOURS:600 COSTS(000):$0 Employer Service and Compensation Reports FORMS: UI-41 UI-41A OMB NO: 3220-0079 EXPIRATION DATE: 08/31/2001 RESPS:2,900 HOURS:487 COSTS(000):$0 Certification Regarding Rights to Unemployment Benefits FORMS: UI-45 OMB NO: 3220-0082 EXPIRATION DATE: 09/30/2003 RESPS:1,040 HOURS:165 COSTS(000):$0 Medicare FORMS: AA-6 AA-7 AA-8 RL-311-F OMB NO: 3220-0083 EXPIRATION DATE: 11/30/2003 RESPS:290 HOURS:121 COSTS(000):$0 Evidence for Application of Overall Minimum FORMS: G-319 G-320 OMB NO: 3220-0086 EXPIRATION DATE: 07/31/2002 RESPS:35 HOURS:6 COSTS(000):$0 Application for Reimbursement for Hospital Services in Canada FORMS: AA-104 OMB NO: 3220-0089 EXPIRATION DATE: 11/30/2002 RESPS:2,240 HOURS:300 COSTS(000):$0 Pension Plan Reports FORMS: G-88P G-88R G-88R.1 OMB NO: 3220-0097 EXPIRATION DATE: 09/30/2001 RESPS:750 HOURS:63 COSTS(000):$0 Pay Rate Report FORMS: UI-1E OMB NO: 3220-0099 EXPIRATION DATE: 06/30/2002 RESPS:100 HOURS:129 COSTS(000):$0 Statement Regarding Contributions and Support FORMS: G-134 OMB NO: 3220-0100 EXPIRATION DATE: 11/30/2002 RESPS:4,100 HOURS:1,025 COSTS(000):$0 Request for Review of Part B Medicare Claim FORMS: G-790 G-791 OMB NO: 3220-0106 EXPIRATION DATE: 07/31/2001 RESPS:75 HOURS:13 COSTS(000):$0 Application for Search of Census Records (Railroad Retirement Purposes Only) FORMS: G-256 OMB NO: 3220-0107 EXPIRATION DATE: 01/31/2003 RESPS:300 HOURS:150 COSTS(000):$0 Request to Non-Railroad Employer for Information About Annuitant's Work and Earnings FORMS: RL-231-F OMB NO: 3220-0123 EXPIRATION DATE: 11/30/2003 RESPS:1,230 HOURS:121 COSTS(000):$0 Student Beneficiary Monitoring FORMS: G-315 G-315A G-315A.1 OMB NO: 3220-0127 EXPIRATION DATE: 06/30/2002 RESPS:1,200 HOURS:1,700 COSTS(000):$0 Financial Disclosure Statement FORMS: G-423 OMB NO: 3220-0131 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Request for Medicare Payment FORMS: G-740S HCFA-1500 OMB NO: 3220-0132 EXPIRATION DATE: 01/31/2003 RESPS:556 HOURS:345 COSTS(000):$0 Gross Earnings Report FORMS: BA-11 OMB NO: 3220-0136 EXPIRATION DATE: 03/31/2001 RESPS:7,700 HOURS:1,202 COSTS(000):$0 Public Service Pension Questionnaires FORMS: G-208 G-212 OMB NO: 3220-0138 EXPIRATION DATE: 03/31/2001 RESPS:1,000 HOURS:691 COSTS(000):$0 Self-Employment Questionnaire FORMS: AA-4 OMB NO: 3220-0140 EXPIRATION DATE: 01/31/2003 RESPS:5,400 HOURS:450 COSTS(000):$0 Employee's Certification FORMS: G-346 OMB NO: 3220-0141 EXPIRATION DATE: 11/30/2003 RESPS:6,000 HOURS:3,045 COSTS(000):$0 Vocational Report FORMS: G-251 OMB NO: 3220-0145 EXPIRATION DATE: 06/30/2003 RESPS:1,500 HOURS:750 COSTS(000):$0 Nonresident Questionnaire FORMS: RRB-1001 OMB NO: 3220-0149 EXPIRATION DATE: 05/31/2001 RESPS:25,000 HOURS:1 COSTS(000):$0 Withholding Certificate for Railroad Retirement Monthly Annuity Payments FORMS: RRB-W-4P OMB NO: 3220-0151 EXPIRATION DATE: 07/31/2001 RESPS:6,535 HOURS:2,032 COSTS(000):$0 Representative Payee Monitoring FORMS: G-99A G-99C OMB NO: 3220-0154 EXPIRATION DATE: 07/31/2002 RESPS:500 HOURS:55 COSTS(000):$0 Employee Noncovered Service Pension Questionnaire FORMS: G-209 OMB NO: 3220-0155 EXPIRATION DATE: 06/30/2001 RESPS:100 HOURS:17 COSTS(000):$0 Supplement to Claim of Person Outside the United States FORMS: G-45 OMB NO: 3220-0156 EXPIRATION DATE: 06/30/2003 RESPS:4,000 HOURS:133 COSTS(000):$0 Employer's Deemed Service Month Questionnaire FORMS: GL-99 OMB NO: 3220-0164 EXPIRATION DATE: 05/31/2002 RESPS:7,600 HOURS:1,085 COSTS(000):$0 Availability for Work FORMS: UI-38 UI-38S ID-8K OMB NO: 3220-0169 EXPIRATION DATE: 06/30/2003 RESPS:300 HOURS:25 COSTS(000):$0 Repayment of Debt FORMS: G-421F OMB NO: 3220-0171 EXPIRATION DATE: 06/30/2002 RESPS:18,600 HOURS:460 COSTS(000):$0 RUIA Claims Notification System FORMS: ID-4K OMB NO: 3220-0173 EXPIRATION DATE: 04/30/2002 RESPS:1,072 HOURS:1,340 COSTS(000):$0 Railroad Separation Allowance or Severance Pay Report FORMS: BA-9 OMB NO: 3220-0175 EXPIRATION DATE: 09/30/2001 RESPS:172 HOURS:158 COSTS(000):$0 Sick Pay and Miscellaneous Payments Report FORMS: BA-10 OMB NO: 3220-0176 EXPIRATION DATE: 05/31/2002 RESPS:1,850 HOURS:154 COSTS(000):$0 Representative Payee Parental Custody Monitoring FORMS: G-99D OMB NO: 3220-0178 EXPIRATION DATE: 07/31/2002 RESPS:3,000 HOURS:300 COSTS(000):$0 Aged Monitoring Questionnaire FORMS: G-19C OMB NO: 3220-0179 EXPIRATION DATE: 08/31/2002 RESPS:5,000 HOURS:1,250 COSTS(000):$0 Annual Earnings Questionnaire for Annuitants in Last Pre-Retirement Non-Railroad Employment FORMS: G-19L OMB NO: 3220-0183 EXPIRATION DATE: 10/31/2003 RESPS:900 HOURS:225 COSTS(000):$0 Statement of Claimant or Other Person FORMS: G-93 OMB NO: 3220-0184 EXPIRATION DATE: 07/31/2001 RESPS:1,500 HOURS:200 COSTS(000):$0 Earnings Information Request FORMS: G-19-F OMB NO: 3220-0185 EXPIRATION DATE: 09/30/2001 RESPS:600 HOURS:100 COSTS(000):$0 Report of Medicare State Office on Beneficiary's Buy-In Status FORMS: RL-380F OMB NO: 3220-0187 EXPIRATION DATE: 08/31/2002 RESPS:3,500 HOURS:790 COSTS(000):$0 Continuing Disability Report FORMS: G-254 G-254A OMB NO: 3220-0192 EXPIRATION DATE: 09/30/2003 RESPS:2,750 HOURS:800 COSTS(000):$0 Voluntary Customer Surveys in Accordance with E.O. 12862 FORMS: G-201 OMB NO: 3220-0193 EXPIRATION DATE: 11/30/2003 RESPS:430 HOURS:144 COSTS(000):$0 Job Information Report FORMS: G-251A G-251B OMB NO: 3220-0194 EXPIRATION DATE: 03/31/2001 RESPS:464 HOURS:209 COSTS(000):$0 Employee Home Address Report FORMS: BA-6A OMB NO: 3220-0195 EXPIRATION DATE: 02/28/2002 RESPS:500 HOURS:500 COSTS(000):$0 Statement Regarding Contributions and Support of Children FORMS: G-139
(RETURN TO AGENCY LIST)OMB NO: 3240-0002 EXPIRATION DATE: 06/30/2002 RESPS:1,271,326 HOURS:42,335 COSTS(000):$0 Selective Service Registration Form FORMS: SSS-1 SSS-1M SSS-1(SRS) OMB NO: 3240-0003 EXPIRATION DATE: 08/31/2002 RESPS:682,781 HOURS:22,736 COSTS(000):$0 SSS Change of Information, SSS Registration Status Form, SSS Acknowledgment and Correction/Change Form FORMS: SSS-2 SSS-3A SSS-3B SSS-3C OMB NO: 3240-0005 EXPIRATION DATE: 10/31/2001 RESPS:1,500 HOURS:375 COSTS(000):$0 Potential Board Member Information FORMS: SSS-404 OMB NO: 3240-0006 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Registrant Claim Form FORMS: SSS-FORM-9 OMB NO: 3240-0010 EXPIRATION DATE: 08/31/2002 RESPS:2,705 HOURS:89 COSTS(000):$0 Uncompensated Registrar Appointment FORMS: SSS-402 OMB NO: 3240-0014 EXPIRATION DATE: 06/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Registrant Travel Reimbursement Request FORMS: SSS-350 OMB NO: 3240-0015 EXPIRATION DATE: 06/30/2001 RESPS:1 HOURS:1 COSTS(000):$0 Application for Voluntary Induction FORMS: 254 OMB NO: 3240-0017 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Application by Alien for Relief from Training and Service in the Armed Forces of the United States FORMS: SSS-130 OMB NO: 3240-0018 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Student Certificate FORMS: SSS-109 OMB NO: 3240-0022 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Claim Documentation Form, Alien or Dual National FORMS: SSS-26 OMB NO: 3240-0023 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Claim Documentation Form, Minister of Religion FORMS: SSS-25 OMB NO: 3240-0024 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Claim Documentation Form, Hardship to Dependents FORMS: SSS-24 OMB NO: 3240-0025 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Claim Documentation Form, Administrative Classifications FORMS: SSS-21 OMB NO: 3240-0026 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Claim Documentation Form, Divinity Student FORMS: SSS-23 OMB NO: 3240-0027 EXPIRATION DATE: 08/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Claim Documentation Form, Postponement of Induction FORMS: SSS-27 OMB NO: 3240-0028 EXPIRATION DATE: 05/31/2003 RESPS:1 HOURS:1 COSTS(000):$0 Claim Documentation Form-Conscientious Objector FORMS: SSS-FORM-22 OMB NO: 3240-0029 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Alternative Service Worker Travel Reimbursement Request FORMS: SS-FORM-164 OMB NO: 3240-0030 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Claim for Reimbursement for Emergency Medical Care FORMS: SSS-FORM-166 OMB NO: 3240-0031 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Employer Data Sheet FORMS: SSS-153 OMB NO: 3240-0032 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Skills Questionnaire FORMS: SSS-FORM-156 OMB NO: 3240-0033 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Alternative Service Job Data Form FORMS: SSS-157 OMB NO: 3240-0034 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Request for Overseas Job Assignment FORMS: SSS-FORM-160 OMB NO: 3240-0035 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Employment Verification Form FORMS: SSS-163 OMB NO: 3240-0036 EXPIRATION DATE: 05/31/2002 RESPS:1 HOURS:1 COSTS(000):$0 Alternative Service Employment Agreement FORMS: SSS-152
(RETURN TO AGENCY LIST)OMB NO: 3245-0007 EXPIRATION DATE: 08/31/2003 RESPS:195,930 HOURS:53,375 COSTS(000):$0 Surety Bond Guarantee Assistance FORMS: SBA-FORMS-990 991 994 994B 994C 994F 994H OMB NO: 3245-0009 EXPIRATION DATE: 03/31/2001 RESPS:4,200 HOURS:700 COSTS(000):$0 Size Status Declaration FORMS: SBA-FORM-480 OMB NO: 3245-0012 EXPIRATION DATE: 09/30/2001 RESPS:146,800 HOURS:231,800 COSTS(000):$0 Requests from Borrowers (Reports, Records, and Financial Statements) FORMS: SBA-FORM-770 OMB NO: 3245-0016 EXPIRATION DATE: 09/30/2001 RESPS:60,000 HOURS:1,187,000 COSTS(000):$0 Applications for Business Loans FORMS: SBA-FORM-4 SBA-FORM-4-L SBA-FORM-4SHORT SBA-FORM-4SCH.A SBA-FORM-4-I OMB NO: 3245-0017 EXPIRATION DATE: 02/28/2002 RESPS:16,853 HOURS:48,561 COSTS(000):$170 Disaster Business Loan Application FORMS: SBA-FORM-5 739A 1368 OMB NO: 3245-0018 EXPIRATION DATE: 09/30/2003 RESPS:53,975 HOURS:80,963 COSTS(000):$0 Disaster Home Loan Application FORMS: SBA-FORM-5C SBA-FORM-739 OMB NO: 3245-0024 EXPIRATION DATE: 10/31/2002 RESPS:200,000 HOURS:50,000 COSTS(000):$0 Pro-Net FORMS: SBA-1167 OMB NO: 3245-0062 EXPIRATION DATE: 03/31/2001 RESPS:90 HOURS:14,400 COSTS(000):$7,020 SBIC License Application; Statement of Personal History and Qualification of Management FORMS: SBA-FORM-415 SBA-FORM-415A OMB NO: 3245-0063 EXPIRATION DATE: 04/30/2001 RESPS:625 HOURS:10,025 COSTS(000):$0 SBIC Financial Reports FORMS: SBA-FORM-468 OMB NO: 3245-0074 EXPIRATION DATE: 12/31/2003 RESPS:270 HOURS:7,560 COSTS(000):$108,000 CDC Annual Report Guide FORMS: 1253 1253A OMB NO: 3245-0078 EXPIRATION DATE: 04/30/2001 RESPS:2,100 HOURS:420 COSTS(000):$0 Portfolio Financing Report FORMS: SBA-1031 OMB NO: 3245-0081 EXPIRATION DATE: 06/30/2002 RESPS:327 HOURS:507 COSTS(000):$0 Small Business Investment Company (SBIC) Leverage Application Forms and Documents, Leverage Application Kits FORMS: SBA-FORMS-25 33 34 1065 OMB NO: 3245-0083 EXPIRATION DATE: 08/31/2001 RESPS:1,200 HOURS:300 COSTS(000):$0 Amendments to License Application FORMS: 415C OMB NO: 3245-0084 EXPIRATION DATE: 06/30/2003 RESPS:53,478 HOURS:13,370 COSTS(000):$0 Disaster Home/Business Loan Inquiry Record FORMS: SBA-FORM-700 OMB NO: 3245-0091 EXPIRATION DATE: 06/30/2001 RESPS:600,000 HOURS:150,000 COSTS(000):$0 Request for Counseling FORMS: SBA-FORM-641 SBA-FORM-641A OMB NO: 3245-0096 EXPIRATION DATE: 10/31/2002 RESPS:469 HOURS:3,752 COSTS(000):$0 Nomination for the Small Business Prime Contractor and Nomination for the Small Business Subcontractor of the Year Award FORMS: SBA-1375 SBA-883 OMB NO: 3245-0101 EXPIRATION DATE: 03/31/2003 RESPS:10,500 HOURS:42,000 COSTS(000):$0 Application for Small Business Size Determination FORMS: SBA-FORM-355 OMB NO: 3245-0109 EXPIRATION DATE: 02/28/2001 RESPS:2,160 HOURS:2,160 COSTS(000):$0 Request for Information Concerning Portfolio Financing FORMS: 857 OMB NO: 3245-0110 EXPIRATION DATE: 03/31/2003 RESPS:30,020 HOURS:15,010 COSTS(000):$0 Borrower's Progress Certification FORMS: SBA-FORM-1366 OMB NO: 3245-0116 EXPIRATION DATE: 02/28/2001 RESPS:750 HOURS:750 COSTS(000):$0 Financial Institution Confirmation Form FORMS: 860 OMB NO: 3245-0118 EXPIRATION DATE: 09/30/2001 RESPS:200 HOURS:200 COSTS(000):$0 Disclosure Statement FORMS: SBA-FORM-856 OMB NO: 3245-0121 EXPIRATION DATE: 06/30/2003 RESPS:57 HOURS:1,140 COSTS(000):$0 Governor's Request for Disaster Declaration FORMS: NONE OMB NO: 3245-0124 EXPIRATION DATE: 04/30/2002 RESPS:700 HOURS:93 COSTS(000):$0 Candidate for Appointment to SBA Advisory Councils and Nomination for Small Business Person of the Year FORMS: 898 OMB NO: 3245-0131 EXPIRATION DATE: 10/31/2001 RESPS:25,284 HOURS:4,214 COSTS(000):$54,360 Transaction Report on Loans Serviced by Lenders FORMS: SBAFORM172 OMB NO: 3245-0136 EXPIRATION DATE: 10/31/2001 RESPS:4,000 HOURS:332 COSTS(000):$3,178 Disaster Survey Worksheet FORMS: SBAFORM987 OMB NO: 3245-0140 EXPIRATION DATE: 06/30/2001 RESPS:427 HOURS:30,141 COSTS(000):$0 Notice of Award -- SBA Form 1222, Grant/Cooperative Agreement Cost Sharing Proposal -- SBA Form 1224 FORMS: SBA-FORM-1222 SBA-FORM-1224 OMB NO: 3245-0141 EXPIRATION DATE: 10/31/2002 RESPS:63 HOURS:1,024 COSTS(000):$0 Prime Contracts Program Quarterly Report; Part A, Traditional PCR and Part B, Breakout PCR FORMS: SBA-FORM-843A FORM-843B OMB NO: 3245-0169 EXPIRATION DATE: 09/30/2003 RESPS:114 HOURS:7,524 COSTS(000):$0 SBDC Program & Financial Reports FORMS: SF-269 SF-272 OMB NO: 3245-0172 EXPIRATION DATE: 03/31/2001 RESPS:600 HOURS:600 COSTS(000):$0 Stockholder's Confirmation (Corporation); Ownership Confirmation (Partnership) FORMS: SBA-FORM-1405 OMB NO: 3245-0178 EXPIRATION DATE: 09/30/2003 RESPS:55,000 HOURS:13,750 COSTS(000):$0 Statement of Personal History FORMS: SBA-FORM-912 OMB NO: 3245-0193 EXPIRATION DATE: 05/31/2002 RESPS:4,200 HOURS:4,200 COSTS(000):$84 Servicing Agent Agreement FORMS: 1506 OMB NO: 3245-0200 EXPIRATION DATE: 06/30/2001 RESPS:17,000 HOURS:12,750 COSTS(000):$0 Settlement Sheet FORMS: 1050 OMB NO: 3245-0212 EXPIRATION DATE: 02/28/2003 RESPS:5,000 HOURS:7,500 COSTS(000):$0 Secondary Market Assignment and Disclosure Form FORMS: SBA-FORM-1088 OMB NO: 3245-0213 EXPIRATION DATE: 09/30/2001 RESPS:450 HOURS:1,350 COSTS(000):$63 Application for Pool of Guaranteed Interest Certificates FORMS: SBA-FORM-1454 OMB NO: 3245-0225 EXPIRATION DATE: 02/28/2003 RESPS:300 HOURS:2,400 COSTS(000):$0 Small Business Administration, Application for Certificate of Comptency FORMS: SBA-FORM-1531 OMB NO: 3245-0228 EXPIRATION DATE: 05/31/2001 RESPS:1,000 HOURS:100 COSTS(000):$0 Client's Report of 7(j) Task Order Service Received FORMS: SBA-FORM-1540 OMB NO: 3245-0298 EXPIRATION DATE: 08/31/2003 RESPS:1,806 HOURS:68 COSTS(000):$0 Business Information Center Customer Satisfaction Survey FORMS: FORM-1916(9-94) OMB NO: 3245-0301 EXPIRATION DATE: 06/30/2001 RESPS:932 HOURS:1,864 COSTS(000):$0 Financing Eligibility Statement, Social Disadvantaged-Economic Disadvantaged FORMS: SBA-FORM-1941-A SBA-FORM-1941-B SBA-FORM-1941-C OMB NO: 3245-0313 EXPIRATION DATE: 12/31/2003 RESPS:200 HOURS:183 COSTS(000):$0 Federal Agency Appraisal Form FORMS: 1993 OMB NO: 3245-0317 EXPIRATION DATE: 10/31/2001 RESPS:30,000 HOURS:90,000 COSTS(000):$0 Small Disadvantaged Business Certification Application FORMS: 2065 OMB NO: 3245-0319 EXPIRATION DATE: 12/31/2001 RESPS:100,000 HOURS:834 COSTS(000):$0 Business Coach Application FORMS: SBA-2063 SBA-2064 OMB NO: 3245-0320 EXPIRATION DATE: 11/30/2002 RESPS:20,000 HOURS:20,000 COSTS(000):$0 HUBZone Empowerment Contracting Program Application FORMS: SBA-2103 OMB NO: 3245-0324 EXPIRATION DATE: 04/30/2003 RESPS:1 HOURS:60,000 COSTS(000):$0 Entrepreneurial Development Management Information System (EDMIS) FORMS: SBA-641 SBA-641A OMB NO: 3245-0326 EXPIRATION DATE: 12/31/2003 RESPS:2,500 HOURS:5,000 COSTS(000):$0 Pre-Disaster Mitigation Small Business Loan Application FORMS: SBA-FORM-5M OMB NO: 3245-0327 EXPIRATION DATE: 12/31/2003 RESPS:1 HOURS:1,244 COSTS(000):$0 Value of Worker Training Programs to Small Business FORMS: NONE OMB NO: 3245-0328 EXPIRATION DATE: 12/31/2003 RESPS:500 HOURS:250 COSTS(000):$0 7(j) Management and Technical Assistance Program Sponsored Training Impact and Longitudinal Studies FORMS: 2167 2168 2169 2170 2171
(RETURN TO AGENCY LIST)OMB NO: 0960-0001 EXPIRATION DATE: 05/31/2001 RESPS:18,000 HOURS:4,500 COSTS(000):$0 Certificate of Support FORMS: SSA-760-F4 OMB NO: 0960-0002 EXPIRATION DATE: 05/31/2002 RESPS:3,000 HOURS:1,500 COSTS(000):$0 Statement Regarding the Inferred Death of an Individual By Reason of Continued and Unexplained Absence FORMS: SSA-723-F4 OMB NO: 0960-0003 EXPIRATION DATE: 09/30/2002 RESPS:45,000 HOURS:12,500 COSTS(000):$0 Application for Mother's or Father's Insurance Benefit FORMS: SSA-5F6 OMB NO: 0960-0004 EXPIRATION DATE: 12/31/2002 RESPS:288,580 HOURS:72,145 COSTS(000):$0 Application for Widow's or Widower's Insurance Benefits FORMS: SSA-10-BK OMB NO: 0960-0007 EXPIRATION DATE: 04/30/2001 RESPS:1,600,000 HOURS:280,000 COSTS(000):$0 Application for Retirement Insurance Benefits FORMS: SSA-1 OMB NO: 0960-0008 EXPIRATION DATE: 01/31/2003 RESPS:700,000 HOURS:175,000 COSTS(000):$0 Application for Wife's or Husband's Insurance Benefits FORMS: SSA-2-F6 OMB NO: 0960-0009 EXPIRATION DATE: 09/30/2002 RESPS:180,000 HOURS:15,000 COSTS(000):$0 Marriage Certification FORMS: SSA-3 OMB NO: 0960-0010 EXPIRATION DATE: 04/30/2001 RESPS:1,740,000 HOURS:372,417 COSTS(000):$0 Application for Child's Insurance Benefits FORMS: SSA-4-BK OMB NO: 0960-0012 EXPIRATION DATE: 09/30/2002 RESPS:1,400 HOURS:350 COSTS(000):$0 Application for Parent's Insurance Benefits FORMS: SSA-7 OMB NO: 0960-0013 EXPIRATION DATE: 01/31/2001 RESPS:735,000 HOURS:122,500 COSTS(000):$0 Application for Lump-Sum Death Payment FORMS: SSA-8-F4 OMB NO: 0960-0014 EXPIRATION DATE: 06/30/2003 RESPS:2,121,686 HOURS:371,295 COSTS(000):$0 Request to be Selected as Payee FORMS: SSA-11-BK OMB NO: 0960-0015 EXPIRATION DATE: 09/30/2003 RESPS:100,000 HOURS:8,333 COSTS(000):$0 Request for Withdrawal of Application FORMS: SSA-521 OMB NO: 0960-0016 EXPIRATION DATE: 08/31/2002 RESPS:1,200 HOURS:200 COSTS(000):$0 Statement Regarding Date of Birth and Citizenship FORMS: SSA-702 OMB NO: 0960-0017 EXPIRATION DATE: 03/31/2002 RESPS:40,000 HOURS:6,000 COSTS(000):$0 Statement Regarding Marriage FORMS: SSA-753 OMB NO: 0960-0019 EXPIRATION DATE: 04/30/2001 RESPS:14,000 HOURS:2,333 COSTS(000):$0 Certificate of Responsibility for Welfare and Care of Child Not in Applicant's Custody FORMS: SSA-781 OMB NO: 0960-0020 EXPIRATION DATE: 08/31/2003 RESPS:30,000 HOURS:7,500 COSTS(000):$0 Statement Regarding Contributions FORMS: SSA-783 OMB NO: 0960-0024 EXPIRATION DATE: 03/31/2001 RESPS:120,000 HOURS:20,000 COSTS(000):$0 Physician's/Medical Officer's Statement of Patient's Capability to Manage Benefits FORMS: SSA-787 OMB NO: 0960-0025 EXPIRATION DATE: 03/31/2003 RESPS:12,350 HOURS:6,175 COSTS(000):$0 Partnership Questionnaire FORMS: SSA-7104 OMB NO: 0960-0029 EXPIRATION DATE: 09/30/2001 RESPS:375,000 HOURS:62,500 COSTS(000):$0 Request for Correction of Earnings Record FORMS: SSA-7008 OMB NO: 0960-0030 EXPIRATION DATE: 05/31/2003 RESPS:925,000 HOURS:308,333 COSTS(000):$0 Statement of Employer FORMS: SSA-7011 OMB NO: 0960-0034 EXPIRATION DATE: 01/31/2003 RESPS:150,000 HOURS:100,000 COSTS(000):$0 Letter to Employer Requesting Information about Wages Earned by Beneficiary FORMS: SSA-L725 OMB NO: 0960-0036 EXPIRATION DATE: 07/31/2001 RESPS:125,000 HOURS:37,500 COSTS(000):$0 Statement of Agricultural Employer (Years Prior to 1988); Statement of Agricultural Employer (1988 and Later) FORMS: SSA-1002-F3 SSA-1003-F3 OMB NO: 0960-0037 EXPIRATION DATE: 05/31/2001 RESPS:500,000 HOURS:1,000,000 COSTS(000):$0 Request for Waiver of Overpayment Recovery or Change in Repayment Rate FORMS: SSA-632-BK OMB NO: 0960-0038 EXPIRATION DATE: 12/31/2002 RESPS:30,000 HOURS:15,000 COSTS(000):$0 Statement of Marital Relationship (By One of the Parties) FORMS: SSA-754 OMB NO: 0960-0040 EXPIRATION DATE: 01/31/2001 RESPS:47,500 HOURS:19,792 COSTS(000):$0 Employment Relationship Questionnaire FORMS: SSA-7160 OMB NO: 0960-0041 EXPIRATION DATE: 08/31/2002 RESPS:10,000 HOURS:500 COSTS(000):$0 State Contribution Form FORMS: SSA-3961 OMB NO: 0960-0045 EXPIRATION DATE: 08/31/2003 RESPS:305,500 HOURS:76,375 COSTS(000):$0 Statement of Claimant or Other Person FORMS: SSA-795 OMB NO: 0960-0046 EXPIRATION DATE: 11/30/2003 RESPS:5,000 HOURS:417 COSTS(000):$0 Statement of Self-Employment Income FORMS: SSA-766 OMB NO: 0960-0049 EXPIRATION DATE: 04/30/2003 RESPS:230,000 HOURS:24,167 COSTS(000):$0 Report to U.S. SSA by Person Receiving Benefits for a Child or Adult Unable to Handle Funds; & Report to U.S. SSA FORMS: SSA-7161-OCR-SM SSA-7162-OCR-SM OMB NO: 0960-0050 EXPIRATION DATE: 01/31/2001 RESPS:20,000 HOURS:4,000 COSTS(000):$0 Questionnaire About Employment or Self-Employment Outside the United States FORMS: SSA-7163 OMB NO: 0960-0051 EXPIRATION DATE: 09/30/2003 RESPS:35,000 HOURS:2,917 COSTS(000):$0 Supplement to claim of Person Outside the United States FORMS: SSA-221 OMB NO: 0960-0052 EXPIRATION DATE: 09/30/2001 RESPS:750,000 HOURS:375,000 COSTS(000):$0 Medical Report (General) FORMS: SSA-3826-F4 OMB NO: 0960-0058 EXPIRATION DATE: 10/31/2002 RESPS:50,000 HOURS:30,000 COSTS(000):$0 Report on Individual with Mental Impairment FORMS: SSA-824 OMB NO: 0960-0059 EXPIRATION DATE: 02/28/2003 RESPS:300,000 HOURS:225,000 COSTS(000):$0 Work Activity Report--Employee FORMS: SSA-821-BK OMB NO: 0960-0060 EXPIRATION DATE: 06/30/2003 RESPS:1,185,942 HOURS:395,314 COSTS(000):$0 Application for Disability Insurance Benefits FORMS: SSA-16 OMB NO: 0960-0061 EXPIRATION DATE: 06/30/2001 RESPS:47,500 HOURS:7,917 COSTS(000):$0 Farm Self-Employment Questionnaire FORMS: SSA-7156 OMB NO: 0960-0062 EXPIRATION DATE: 01/31/2002 RESPS:3,200 HOURS:800 COSTS(000):$0 Application for Survivor Benefits FORMS: SSA-24 OMB NO: 0960-0064 EXPIRATION DATE: 08/31/2002 RESPS:38,000 HOURS:19,000 COSTS(000):$0 Farm Arrangement Questionnaire FORMS: SSA-7157-F4 OMB NO: 0960-0066 EXPIRATION DATE: 04/30/2001 RESPS:16,000,000 HOURS:2,275,000 COSTS(000):$0 Application for a Social Security Card FORMS: SS-5 OMB NO: 0960-0068 EXPIRATION DATE: 11/30/2001 RESPS:5,450,173 HOURS:1,362,543 COSTS(000):$0 Representative Payee Report FORMS: SSA-623 SSA-6230 OMB NO: 0960-0069 EXPIRATION DATE: 09/30/2001 RESPS:250,000 HOURS:125,000 COSTS(000):$0 Representative Payee Evaluation Report FORMS: SSA-624-F5 OMB NO: 0960-0071 EXPIRATION DATE: 03/31/2003 RESPS:27,000 HOURS:2,250 COSTS(000):$0 Report of New Information in Disability Cases FORMS: SSA-612 OMB NO: 0960-0072 EXPIRATION DATE: 01/31/2002 RESPS:855,000 HOURS:427,500 COSTS(000):$0 Report of Continuing Disability Interview FORMS: SSA-454-BK OMB NO: 0960-0073 EXPIRATION DATE: 01/31/2003 RESPS:70,000 HOURS:5,833 COSTS(000):$0 Reporting Changes That Affect Your Social Security Payment FORMS: SSA-1425 OMB NO: 0960-0078 EXPIRATION DATE: 02/28/2002 RESPS:125,000 HOURS:10,417 COSTS(000):$0 Railroad Employment Questionnaire FORMS: SSA-671 OMB NO: 0960-0084 EXPIRATION DATE: 09/30/2002 RESPS:7,000 HOURS:2,333 COSTS(000):$0 Report on Individual with Childhood Impairment FORMS: SSA-1323 OMB NO: 0960-0086 EXPIRATION DATE: 08/31/2001 RESPS:200 HOURS:47 COSTS(000):$0 Chinese Custom Marriage Statement, Statement Regarding Chinese Custom Marriage FORMS: SSA-1344 SSA-1345 OMB NO: 0960-0088 EXPIRATION DATE: 12/31/2002 RESPS:75,000 HOURS:7,500 COSTS(000):$0 Student Reporting Form FORMS: SSA-1383 OMB NO: 0960-0089 EXPIRATION DATE: 10/31/2002 RESPS:200,000 HOURS:33,333 COSTS(000):$0 Report of Student Beneficiary at End of School Year FORMS: SSA-1388 OMB NO: 0960-0090 EXPIRATION DATE: 01/31/2002 RESPS:5,000 HOURS:833 COSTS(000):$0 Statement by School Official About Student's Attendance FORMS: SSA-1371 OMB NO: 0960-0093 EXPIRATION DATE: 09/30/2003 RESPS:180 HOURS:45 COSTS(000):$0 Certification by Religious Group FORMS: SSA-1458 OMB NO: 0960-0096 EXPIRATION DATE: 11/30/2003 RESPS:10 HOURS:3 COSTS(000):$0 Application for Special Age-72-or-Over FORMS: SSA-19-F6 OMB NO: 0960-0097 EXPIRATION DATE: 11/30/2003 RESPS:18,000 HOURS:3,600 COSTS(000):$0 Application for Search of Census Record for Proof of Age FORMS: SSA-1535 OMB NO: 0960-0098 EXPIRATION DATE: 06/30/2002 RESPS:140,000 HOURS:35,000 COSTS(000):$0 Request for Workers' Compensation/Public Disability Benefit Information FORMS: SSA-1709 OMB NO: 0960-0101 EXPIRATION DATE: 06/30/2003 RESPS:300,000 HOURS:50,000 COSTS(000):$0 Claim for Amounts Due in the Case of a Deceased Beneficiary FORMS: SSA-1724 OMB NO: 0960-0102 EXPIRATION DATE: 01/31/2002 RESPS:12,000 HOURS:6,000 COSTS(000):$0 Medical Report (Individual with Childhood Impairment) FORMS: SSA-3827 OMB NO: 0960-0103 EXPIRATION DATE: 06/30/2001 RESPS:1,000 HOURS:1,000 COSTS(000):$0 Supplemental Statement Regarding Farming Activities of Person Living Outside the U.S.A. FORMS: SSA-7163A OMB NO: 0960-0104 EXPIRATION DATE: 08/31/2002 RESPS:34,624 HOURS:17,312 COSTS(000):$0 Petition to Obtain Approval of a Fee for Representing a Claimant Before the Social Security Administration FORMS: SSA-1560-U4 OMB NO: 0960-0105 EXPIRATION DATE: 08/31/2001 RESPS:200,000 HOURS:33,333 COSTS(000):$0 Student's Statement Regarding School Attendance FORMS: SSA-1372 OMB NO: 0960-0109 EXPIRATION DATE: 09/30/2003 RESPS:130,000 HOURS:21,667 COSTS(000):$0 Statement of Care and Responsibility for Beneficiary FORMS: SSA-788 OMB NO: 0960-0110 EXPIRATION DATE: 05/31/2002 RESPS:183 HOURS:183 COSTS(000):$0 State Mental Institution Policy Review FORMS: SSA-9584 OMB NO: 0960-0112 EXPIRATION DATE: 04/30/2001 RESPS:8,000 HOURS:2,000 COSTS(000):$0 Report by Former Representative Payee FORMS: SSA-625 OMB NO: 0960-0113 EXPIRATION DATE: 09/30/2001 RESPS:50 HOURS:8 COSTS(000):$0 Statement Regarding Student's Attendance FORMS: SSA-2434 OMB NO: 0960-0116 EXPIRATION DATE: 02/28/2001 RESPS:50,000 HOURS:12,500 COSTS(000):$0 Child Relationship Statement FORMS: SSA-2519 OMB NO: 0960-0118 EXPIRATION DATE: 03/31/2001 RESPS:1,800 HOURS:330 COSTS(000):$0 Application for Benefits under the Federal Mine Safety and Health Act (Widow's, Child's and Dependent Claims) FORMS: SSA-47 SSA-48 SSA-49 OMB NO: 0960-0120 EXPIRATION DATE: 04/30/2001 RESPS:56,000 HOURS:9,333 COSTS(000):$0 Pre-1957 Military Service Federal Benefit Questionnaire FORMS: SSA-2512 OMB NO: 0960-0124 EXPIRATION DATE: 01/31/2003 RESPS:355,000 HOURS:147,917 COSTS(000):$0 Statement of Income and Resources FORMS: SSA-8010-BK OMB NO: 0960-0127 EXPIRATION DATE: 01/31/2002 RESPS:20,000 HOURS:3,333 COSTS(000):$0 Agreement to Sell Property FORMS: SSA-8060 OMB NO: 0960-0128 EXPIRATION DATE: 11/30/2001 RESPS:33,200 HOURS:2,767 COSTS(000):$0 Reporting Events, SSI FORMS: SSA-8150-EV OMB NO: 0960-0130 EXPIRATION DATE: 03/31/2002 RESPS:120 HOURS:120 COSTS(000):$0 Quarterly Statistical Report on Recipients and Payments under State-Administered Assistance Programs for Aged.... FORMS: SSA-9741 OMB NO: 0960-0133 EXPIRATION DATE: 03/31/2003 RESPS:15,000 HOURS:15,000 COSTS(000):$0 Supplemental Security Income (SSI) - Quality Review Case Analysis FORMS: SSA-8508-BK OMB NO: 0960-0138 EXPIRATION DATE: 05/31/2003 RESPS:133,000 HOURS:66,500 COSTS(000):$0 Letter to Employer Requesting Wage Information FORMS: SSA-L4201 OMB NO: 0960-0140 EXPIRATION DATE: 08/31/2002 RESPS:2,134,100 HOURS:177,842 COSTS(000):$0 Record of SSI Inquiry FORMS: SSA-3462 OMB NO: 0960-0141 EXPIRATION DATE: 04/30/2001 RESPS:36,500 HOURS:18,250 COSTS(000):$0 Disability Report, Adult FORMS: SSA-3368-BK OMB NO: 0960-0142 EXPIRATION DATE: 03/31/2002 RESPS:900,000 HOURS:52,500 COSTS(000):$0 Statement of Death by Funeral Director FORMS: SSA-721 OMB NO: 0960-0143 EXPIRATION DATE: 07/31/2001 RESPS:133,000 HOURS:13,300 COSTS(000):$0 Student's Statement Regarding Resumption of School Attendance FORMS: SSA-1386 OMB NO: 0960-0144 EXPIRATION DATE: 01/31/2002 RESPS:400,000 HOURS:200,000 COSTS(000):$0 Reconsideration Disability Report FORMS: SSA-3441 OMB NO: 0960-0145 EXPIRATION DATE: 12/31/2003 RESPS:1,720,000 HOURS:367,334 COSTS(000):$0 Statement of Continuing Eligibility, Supplemental Security Income Payment(s) FORMS: SSA-8202-F6 SSA-8202-OCR-SM OMB NO: 0960-0160 EXPIRATION DATE: 06/30/2002 RESPS:76,000 HOURS:15,833 COSTS(000):$0 Government Pension Questionnaire FORMS: SSA-3885 OMB NO: 0960-0174 EXPIRATION DATE: 12/31/2002 RESPS:438,400 HOURS:51,147 COSTS(000):$0 Statement of Living Arrangement, In-Kind Support and Maintenance FORMS: SSA-8006-F4 OMB NO: 0960-0184 EXPIRATION DATE: 03/31/2003 RESPS:202 HOURS:2,828 COSTS(000):$0 Instructions for Completion of Federal Assistance Application Demonstration Grant Programs FORMS: SSA-96 OMB NO: 0960-0189 EXPIRATION DATE: 09/30/2001 RESPS:10,365 HOURS:4,706 COSTS(000):$0 RSI/DI Quality Review Case Analysis-Sampled Number Holder, Auxiliaries/Survivors, -Parent, Stewardship AET Workbook FORMS: SSA-2930 SSA-2931 SSA-2932 SSA-4659 OMB NO: 0960-0229 EXPIRATION DATE: 01/31/2003 RESPS:1,002,773 HOURS:422,835 COSTS(000):$0 Application for Supplemental Security Income FORMS: SSA-8000-BK OMB NO: 0960-0240 EXPIRATION DATE: 11/30/2003 RESPS:71 HOURS:71 COSTS(000):$0 Subpart T--State Supplementation Provisions; Agreement; Payments, 20 CFR 416.2099 FORMS: NONE OMB NO: 0960-0247 EXPIRATION DATE: 11/30/2002 RESPS:100,000 HOURS:25,000 COSTS(000):$0 Worker's Compensation/Public Disability Benefit Questionnaire FORMS: SSA-546 OMB NO: 0960-0267 EXPIRATION DATE: 01/31/2003 RESPS:60,000 HOURS:3,000 COSTS(000):$0 Medicaid Use Report -- 20 CFR 216.628 FORMS: NONE OMB NO: 0960-0269 EXPIRATION DATE: 08/31/2002 RESPS:515,817 HOURS:85,970 COSTS(000):$0 Request for Hearing by Administrative Law Judge FORMS: HA-501 OMB NO: 0960-0274 EXPIRATION DATE: 09/30/2001 RESPS:50,000 HOURS:4,167 COSTS(000):$0 Report of Student Beneficiary About to Attain Age 19 FORMS: SSA-1390 OMB NO: 0960-0277 EXPIRATION DATE: 08/31/2002 RESPS:103,932 HOURS:17,322 COSTS(000):$0 Request for Review of Hearing Decision/Order FORMS: HA-520 OMB NO: 0960-0282 EXPIRATION DATE: 03/31/2003 RESPS:8,000 HOURS:2,000 COSTS(000):$0 Vocational Rehabilitation "301" Program Development FORMS: 4290 OMB NO: 0960-0288 EXPIRATION DATE: 04/30/2001 RESPS:10,548 HOURS:879 COSTS(000):$0 Notice Regarding Substitution of Party Upon Death of Claimant FORMS: HA-539 OMB NO: 0960-0289 EXPIRATION DATE: 05/31/2003 RESPS:171,939 HOURS:42,985 COSTS(000):$0 Claimant's Medications FORMS: HA-4632 OMB NO: 0960-0292 EXPIRATION DATE: 03/31/2003 RESPS:309,490 HOURS:51,582 COSTS(000):$0 Claimant's Recent Medical Treatment FORMS: HA-4631 OMB NO: 0960-0293 EXPIRATION DATE: 09/30/2001 RESPS:500,000 HOURS:50,000 COSTS(000):$0 Authorization for the Social Security Administration to Obtain Account Records from a Financial Institution and Request for Records FORMS: SSA-4641-U2 OMB NO: 0960-0300 EXPIRATION DATE: 09/30/2002 RESPS:120,000 HOURS:30,000 COSTS(000):$0 Claimant's Work Background FORMS: HA-4633 OMB NO: 0960-0310 EXPIRATION DATE: 11/30/2003 RESPS:90 HOURS:9,048 COSTS(000):$0 Vocational Rehabilitation Provider Claim FORMS: SSA-199-U2 OMB NO: 0960-0314 EXPIRATION DATE: 12/31/2002 RESPS:150 HOURS:16 COSTS(000):$0 Black Lung Student's Statement Regarding Resumption of School Attendance; Report of Black Lung Student Beneficiary at End of School Year FORMS: SSA-2602 SSA-2613 OMB NO: 0960-0316 EXPIRATION DATE: 03/31/2001 RESPS:438,444 HOURS:109,611 COSTS(000):$0 Claimant's Statement When Request for Hearing Is Filed and the FORMS: HA-4486 OMB NO: 0960-0323 EXPIRATION DATE: 06/30/2003 RESPS:95,000 HOURS:7,917 COSTS(000):$0 Third Party Liability Information Statement FORMS: SSA-8019-U2 OMB NO: 0960-0324 EXPIRATION DATE: 01/31/2003 RESPS:7,500 HOURS:1,250 COSTS(000):$0 Supplemental Security Income Claim Information Notice FORMS: SSA-L8050 OMB NO: 0960-0341 EXPIRATION DATE: 09/30/2001 RESPS:2,400 HOURS:80 COSTS(000):$0 Request for Address Information from Motor Vehicles Records; Request for Address Information from Employment Commissions Records FORMS: SSA-L711 SSA-L712 OMB NO: 0960-0347 EXPIRATION DATE: 07/31/2001 RESPS:1,925 HOURS:963 COSTS(000):$0 Response to Notice of Revised Determination FORMS: SSA-765 OMB NO: 0960-0348 EXPIRATION DATE: 09/30/2001 RESPS:7,483 HOURS:998 COSTS(000):$0 Request for Change in Time/Place of Disability Hearing FORMS: SSA-769 OMB NO: 0960-0349 EXPIRATION DATE: 09/30/2001 RESPS:15,015 HOURS:3,003 COSTS(000):$0 Request for Reconsideration, Disability Cessation FORMS: SSA-789 OMB NO: 0960-0350 EXPIRATION DATE: 05/31/2001 RESPS:100,000 HOURS:50,000 COSTS(000):$0 Reconsideration Report for Disability Cessation FORMS: SSA-782-BK OMB NO: 0960-0351 EXPIRATION DATE: 09/30/2001 RESPS:1,200 HOURS:100 COSTS(000):$0 Notice Regarding Substitution of Party Upon Death of Claimant; Reconsideration of Disability Cessation FORMS: SSA-770 OMB NO: 0960-0369 EXPIRATION DATE: 12/31/2003 RESPS:225,000 HOURS:37,500 COSTS(000):$0 Annual Earnings Test--Direct Mail Follow-Up Program Notices FORMS: SSA-L9778 SSA-L9779 SSA-L9781 SSA-L9784 SSA-L9785 OMB NO: 0960-0371 EXPIRATION DATE: 03/31/2002 RESPS:1,000 HOURS:250 COSTS(000):$0 Application for U.S. Benefits under the Canada-U.S. International Social Security Agreement FORMS: SSA-1294-F6-CN OMB NO: 0960-0384 EXPIRATION DATE: 09/30/2003 RESPS:208 HOURS:1,248 COSTS(000):$0 SSA/DDS Cost-Effectiveness Measurement System (CEMS) Data Reporting form FORMS: SSA-1461 OMB NO: 0960-0395 EXPIRATION DATE: 01/31/2002 RESPS:90,000 HOURS:12,000 COSTS(000):$0 Modified Benefit Formula Questionnaire FORMS: SSA-150 OMB NO: 0960-0398 EXPIRATION DATE: 03/31/2003 RESPS:30,000 HOURS:1,000 COSTS(000):$0 Certificate of Election for Reduced Spouse's Benefits FORMS: 25 OMB NO: 0960-0406 EXPIRATION DATE: 04/30/2003 RESPS:216 HOURS:216 COSTS(000):$0 State Agency Schedule for Equipment Purchases for SSA Disability Programs FORMS: SSA-871 OMB NO: 0960-0408 EXPIRATION DATE: 01/31/2002 RESPS:216 HOURS:108 COSTS(000):$0 Time Report of Personnel Services for Disability Determination Services FORMS: SSA-4514 OMB NO: 0960-0413 EXPIRATION DATE: 09/30/2003 RESPS:1,005,804 HOURS:251,451 COSTS(000):$0 Psychiatric Review Technique FORMS: SSA-2506 OMB NO: 0960-0416 EXPIRATION DATE: 11/30/2003 RESPS:920,000 HOURS:260,667 COSTS(000):$0 Statement for Determining Continuing Eligibility, Supplemental Security Income Payments FORMS: SSA-8203-BK OMB NO: 0960-0421 EXPIRATION DATE: 10/31/2003 RESPS:216 HOURS:216 COSTS(000):$0 State Agency Report of Obligations for SSA Disability Programs FORMS: SSA-4513 OMB NO: 0960-0425 EXPIRATION DATE: 08/31/2002 RESPS:484 HOURS:434 COSTS(000):$0 Coverage of Employees of State and Local Governments FORMS: NONE OMB NO: 0960-0428 EXPIRATION DATE: 07/31/2001 RESPS:36 HOURS:18 COSTS(000):$0 Subpoena, Disability Hearing FORMS: SSA-1272-U4 OMB NO: 0960-0429 EXPIRATION DATE: 07/31/2001 RESPS:100 HOURS:8 COSTS(000):$0 Notification of Projected Completion Date FORMS: SSA-891 OMB NO: 0960-0430 EXPIRATION DATE: 09/30/2001 RESPS:22,024 HOURS:5,506 COSTS(000):$0 Summary of Evidence FORMS: SSA-887 OMB NO: 0960-0431 EXPIRATION DATE: 06/30/2003 RESPS:1,130,772 HOURS:376,924 COSTS(000):$0 Physical Residual Functional Capacity Assessment; Mental Residual Functional Capacity Assessment FORMS: SSA-4734-BK SSA-4734-F4-SUP OMB NO: 0960-0432 EXPIRATION DATE: 10/31/2002 RESPS:360,000 HOURS:180,000 COSTS(000):$0 Missing and Discrepant Wage Reports Letter and Questionnaire FORMS: SSA-L93 SSA-95 SSA-97 OMB NO: 0960-0434 EXPIRATION DATE: 09/30/2001 RESPS:50,000 HOURS:8,333 COSTS(000):$0 Payment of Certain Travel Expenses FORMS: NONE OMB NO: 0960-0437 EXPIRATION DATE: 11/30/2001 RESPS:3,578,210 HOURS:894,553 COSTS(000):$0 Disability Determination and Transmittal FORMS: SSA-831-U3/C3 OMB NO: 0960-0440 EXPIRATION DATE: 08/31/2001 RESPS:100,000 HOURS:100,000 COSTS(000):$0 Disability Hearing Officer's Report on Disability Hearing FORMS: SSA-1205-BK OMB NO: 0960-0441 EXPIRATION DATE: 07/31/2001 RESPS:100,000 HOURS:75,000 COSTS(000):$0 Disability Hearing Officer's Decision FORMS: SSA-1207 SSA-1207-SUP-1 SSA-1207-SUP-3 SSA-1207-SUP-4 SSA-1207-SUP-5 OMB NO: 0960-0442 EXPIRATION DATE: 11/30/2001 RESPS:439,037 HOURS:219,519 COSTS(000):$0 Cessation or Continuance of Disability or Blindness Determination FORMS: SSA-833-U3 OMB NO: 0960-0443 EXPIRATION DATE: 11/30/2001 RESPS:646,950 HOURS:323,475 COSTS(000):$0 Cessation or Continuance of Disability or Blindness Determination FORMS: SSA-832-U3/C3 OMB NO: 0960-0444 EXPIRATION DATE: 11/30/2002 RESPS:1,011,046 HOURS:252,762 COSTS(000):$0 Application for Supplemental Security Income FORMS: SSA-8001 OMB NO: 0960-0445 EXPIRATION DATE: 08/31/2001 RESPS:200 HOURS:67 COSTS(000):$0 Application for Benefits, Italy-U.S.A. Agreement on Social Security FORMS: SSA-2528-F4-IT OMB NO: 0960-0448 EXPIRATION DATE: 06/30/2002 RESPS:20,000 HOURS:10,000 COSTS(000):$0 Application for Benefits under a U.S. International Social Security Agreement FORMS: SSA-2490-BK OMB NO: 0960-0451 EXPIRATION DATE: 01/31/2003 RESPS:9,000 HOURS:750 COSTS(000):$0 Permanent Residence under Color of Law (PRUCOL) FORMS: NONE OMB NO: 0960-0454 EXPIRATION DATE: 08/31/2002 RESPS:49,000 HOURS:8,167 COSTS(000):$0 Letter to Landlord Requesting Rental Information FORMS: SSA-L5061 OMB NO: 0960-0456 EXPIRATION DATE: 09/30/2001 RESPS:400,000 HOURS:100,000 COSTS(000):$0 Statement of Household Expenses and Contributions FORMS: SSA-8011-F3 OMB NO: 0960-0460 EXPIRATION DATE: 12/31/2002 RESPS:5,100 HOURS:425 COSTS(000):$0 Marital Relationship Questionnaire FORMS: SSA-4178 OMB NO: 0960-0461 EXPIRATION DATE: 07/31/2001 RESPS:200,000 HOURS:23,333 COSTS(000):$0 Information About Joint Checking/Savings Account FORMS: SSA-2574 OMB NO: 0960-0462 EXPIRATION DATE: 11/30/2003 RESPS:19,000 HOURS:1,583 COSTS(000):$0 You Can Make Your Payment by Credit Card FORMS: SSA-4588 SSA-4589 OMB NO: 0960-0466 EXPIRATION DATE: 04/30/2001 RESPS:3,350,000 HOURS:279,167 COSTS(000):$0 Request for Earnings and Benefit Estimate Statement FORMS: SSA-7004 OMB NO: 0960-0470 EXPIRATION DATE: 09/30/2001 RESPS:1,000 HOURS:50 COSTS(000):$0 Agency/Employer Government Pension Offset Questionnaire FORMS: SSA-L4163 OMB NO: 0960-0471 EXPIRATION DATE: 07/31/2001 RESPS:5,438 HOURS:1,813 COSTS(000):$0 Real Property Current Market Value Estimate FORMS: SSA-L2794 OMB NO: 0960-0472 EXPIRATION DATE: 06/30/2001 RESPS:50,000 HOURS:8,333 COSTS(000):$0 Employer Verification of Earnings After Death FORMS: SSA-L4112 OMB NO: 0960-0473 EXPIRATION DATE: 09/30/2001 RESPS:4,750 HOURS:792 COSTS(000):$1 Employee Identification Statement FORMS: SSA-4156 OMB NO: 0960-0474 EXPIRATION DATE: 09/30/2001 RESPS:2,000 HOURS:167 COSTS(000):$0 Child Care Dropout Questionnaire FORMS: SSA-4162 OMB NO: 0960-0477 EXPIRATION DATE: 01/31/2002 RESPS:30,000 HOURS:10,000 COSTS(000):$0 Modified Benefits Formula Questionnaire, Employer FORMS: SSA-58 OMB NO: 0960-0481 EXPIRATION DATE: 03/31/2003 RESPS:40,000 HOURS:6,667 COSTS(000):$0 Statement of Funds You Provided to Another, Statement of Funds You Received FORMS: 2854 2855 OMB NO: 0960-0483 EXPIRATION DATE: 06/30/2002 RESPS:12,500 HOURS:3,125 COSTS(000):$0 Employee Work Activity Report FORMS: SSA-3033 OMB NO: 0960-0487 EXPIRATION DATE: 08/31/2002 RESPS:50,000 HOURS:16,667 COSTS(000):$0 Self-Employment Corporation Officer Questionnaire FORMS: SSA-4184 OMB NO: 0960-0492 EXPIRATION DATE: 03/31/2001 RESPS:50,000 HOURS:4,167 COSTS(000):$0 Request for SSI Benefit Estimate FORMS: SS-3716 OMB NO: 0960-0499 EXPIRATION DATE: 03/31/2001 RESPS:132,000 HOURS:66,000 COSTS(000):$0 Questionnaire for Children Claiming SSI Benefits FORMS: SSA-3881 OMB NO: 0960-0500 EXPIRATION DATE: 11/30/2002 RESPS:59,100 HOURS:9,850 COSTS(000):$0 Medical Report on Adult with Allegation of Human Immune Deficiency Virus Infection and Medical Report on Child with Allegation of Human Immune Deficiency Virus Infection FORMS: SSA-4814-F5 SSA-4815-F6 OMB NO: 0960-0501 EXPIRATION DATE: 02/28/2001 RESPS:50 HOURS:13 COSTS(000):$0 Blood Donor Locator Service FORMS: 209F OMB NO: 0960-0502 EXPIRATION DATE: 07/31/2001 RESPS:163,000 HOURS:13,583 COSTS(000):$0 Beneficiary Recontact Report FORMS: SSA-1588-OCR-SM OMB NO: 0960-0504 EXPIRATION DATE: 03/31/2001 RESPS:10,900 HOURS:7,267 COSTS(000):$0 Disablity Report, Child FORMS: SSA-3820-OCR-BK OMB NO: 0960-0505 EXPIRATION DATE: 06/30/2001 RESPS:20,000 HOURS:3,333 COSTS(000):$0 Employer Verification or Records for Children under Age 7 FORMS: SSA-L3231-C1 OMB NO: 0960-0507 EXPIRATION DATE: 08/31/2001 RESPS:100,000 HOURS:100,000 COSTS(000):$0 Disability Hearing Officer's Report of Disability Hearing (DC) FORMS: SSA-1204-BK OMB NO: 0960-0508 EXPIRATION DATE: 10/31/2003 RESPS:3,000,000 HOURS:500,000 COSTS(000):$0 Requests for Self-Employment Information, Employee Information, Employer Information FORMS: SSA-L2765 SSA-L3365 SSA-L4002 OMB NO: 0960-0511 EXPIRATION DATE: 08/31/2002 RESPS:974,000 HOURS:243,500 COSTS(000):$0 Disability Update Report FORMS: SSA-455 SSA-455-OCR-SM OMB NO: 0960-0516 EXPIRATION DATE: 08/31/2002 RESPS:60,000 HOURS:5,000 COSTS(000):$0 Continuation of Full Benefit Standard for Persons Institutionalized -- 20 CFR 416.212 FORMS: NONE OMB NO: 0960-0517 EXPIRATION DATE: 09/30/2002 RESPS:246 HOURS:41 COSTS(000):$0 State Report of Incorrect Bendex Information FORMS: SSA-1086-U5 OMB NO: 0960-0525 EXPIRATION DATE: 09/30/2001 RESPS:44,000 HOURS:7,333 COSTS(000):$0 Request for Social Security Earnings Information FORMS: SSA-7050 OMB NO: 0960-0526 EXPIRATION DATE: 12/31/2002 RESPS:31,514 HOURS:113,775 COSTS(000):$0 Voluntary Customer Surveys in Accordance with E.O. 12862 FORMS: NONE OMB NO: 0960-0527 EXPIRATION DATE: 06/30/2003 RESPS:412,653 HOURS:68,776 COSTS(000):$0 Appointment of Representative FORMS: SSA-1696-U4 OMB NO: 0960-0529 EXPIRATION DATE: 11/30/2003 RESPS:131,080 HOURS:21,847 COSTS(000):$0 Claimant's Statement About Loan of Food or Shelter & Statement About Food or Shelter Provided to Another FORMS: SSA-5062 SSA-L5063 OMB NO: 0960-0531 EXPIRATION DATE: 09/30/2001 RESPS:100,000 HOURS:25,000 COSTS(000):$0 Social Security Request for Information FORMS: SSA-6231 OMB NO: 0960-0534 EXPIRATION DATE: 12/31/2003 RESPS:194 HOURS:49 COSTS(000):$0 Waiver of Right to Appear, Disability Hearing FORMS: SSA-773-U4 OMB NO: 0960-0536 EXPIRATION DATE: 01/31/2001 RESPS:835,492 HOURS:41,775 COSTS(000):$0 Beneficiary Recontact Report FORMS: SSA-1587-OCR-SM OMB NO: 0960-0540 EXPIRATION DATE: 04/30/2001 RESPS:250,000 HOURS:62,500 COSTS(000):$0 Pain Report, Child FORMS: SSA-3371-BK OMB NO: 0960-0542 EXPIRATION DATE: 06/30/2001 RESPS:500,000 HOURS:166,667 COSTS(000):$0 Function Report, Child (Birth to 1st, Age 1 to 3rd, Age 3 to 6th, Age 6 to 12th, Age 12 to 18th Birthday) FORMS: SSA-3375 3376 3377 3378 3379 OMB NO: 0960-0544 EXPIRATION DATE: 08/31/2002 RESPS:24,000 HOURS:400 COSTS(000):$0 Public Information Campaign FORMS: NONE OMB NO: 0960-0546 EXPIRATION DATE: 10/31/2002 RESPS:100,000 HOURS:16,666 COSTS(000):$0 Supplemental Security Income Notice of Interim Assistance Reimbursement FORMS: SSA-8125 SSA-L8125-F6 OMB NO: 0960-0547 EXPIRATION DATE: 07/31/2001 RESPS:1,211 HOURS:606 COSTS(000):$0 Wage Reports and Pension Information FORMS: OR-418P OMB NO: 0960-0549 EXPIRATION DATE: 06/30/2001 RESPS:10,000 HOURS:833 COSTS(000):$0 Request to Have Supplemental Security Income Overpayment Withheld from My Social Security Benefits FORMS: SSA-730-U2 OMB NO: 0960-0552 EXPIRATION DATE: 04/30/2001 RESPS:32,000 HOURS:16,000 COSTS(000):$0 Work History Report FORMS: SSA-3369-BK OMB NO: 0960-0554 EXPIRATION DATE: 09/30/2001 RESPS:34,000 HOURS:18,200 COSTS(000):$0 Certificate of Coverage Request FORMS: NONE OMB NO: 0960-0555 EXPIRATION DATE: 02/28/2002 RESPS:14,043,700 HOURS:3,372,117 COSTS(000):$0 Generic Clearance of Information Collections Conducted by State Disability Determinations Services on Behalf of SSA FORMS: NONE OMB NO: 0960-0557 EXPIRATION DATE: 08/31/2002 RESPS:2,100 HOURS:105 COSTS(000):$0 Inquiry to File an SSI Child's Application FORMS: SSRO-3-293 OMB NO: 0960-0559 EXPIRATION DATE: 09/30/2001 RESPS:10,000 HOURS:20,000 COSTS(000):$0 Plan for Achieving Self-Support FORMS: SSA-545 OMB NO: 0960-0561 EXPIRATION DATE: 05/31/2001 RESPS:50,000 HOURS:12,500 COSTS(000):$0 Modified Benefit Formula Questionnaire, Foreign Pension FORMS: SSA-308 OMB NO: 0960-0564 EXPIRATION DATE: 01/31/2003 RESPS:3,950,000 HOURS:197,500 COSTS(000):$0 QuickStart Enrollment Form FORMS: NONE OMB NO: 0960-0565 EXPIRATION DATE: 02/28/2002 RESPS:100,000 HOURS:33,367 COSTS(000):$0 Employer Report of Special Wage Payments FORMS: SSA-131 OMB NO: 0960-0566 EXPIRATION DATE: 05/31/2003 RESPS:2,228,500 HOURS:119,133 COSTS(000):$0 Privacy and Disclosure of Official Records and Information; Availability of Information and Records to the Public; 20-CFR 401 & 402 FORMS: SSA-3288 OMB NO: 0960-0568 EXPIRATION DATE: 11/30/2003 RESPS:750,000 HOURS:312,500 COSTS(000):$0 Childhood Disability Evaluation Form FORMS: SSA-538 OMB NO: 0960-0575 EXPIRATION DATE: 02/28/2001 RESPS:550,000 HOURS:18,334 COSTS(000):$0 Request to Resolve Questionable Quarters of Coverage (QC); Request for QC History Based on Relationship FORMS: SSA-512 SSA-513 OMB NO: 0960-0576 EXPIRATION DATE: 03/31/2001 RESPS:30,000 HOURS:10,000 COSTS(000):$0 Representative Payee Report of Benefits and Dedicated Account FORMS: SSA-6233 OMB NO: 0960-0577 EXPIRATION DATE: 07/31/2001 RESPS:523,000 HOURS:348,667 COSTS(000):$0 Disability Report, Child FORMS: SSA-3820-BK OMB NO: 0960-0578 EXPIRATION DATE: 07/31/2001 RESPS:1,000,000 HOURS:500,000 COSTS(000):$0 Work History Report FORMS: SSA-3369-BK OMB NO: 0960-0579 EXPIRATION DATE: 07/31/2001 RESPS:2,438,500 HOURS:1,219,250 COSTS(000):$0 Disability Report, Adult FORMS: SSA-3368-BK OMB NO: 0960-0581 EXPIRATION DATE: 12/31/2003 RESPS:100,000 HOURS:28,333 COSTS(000):$0 Application of Circuit Court Law FORMS: 20CFR404.985(B) 20CFR416.1485B OMB NO: 0960-0583 EXPIRATION DATE: 01/31/2001 RESPS:7,000 HOURS:583 COSTS(000):$0 Request for Replacement SSA-1099/SSA-1042S Social Security Benefits Statement FORMS: NONE OMB NO: 0960-0585 EXPIRATION DATE: 03/31/2001 RESPS:250 HOURS:250 COSTS(000):$0 Discrimination Complaint Form FORMS: SSA-437 OMB NO: 0960-0588 EXPIRATION DATE: 02/28/2003 RESPS:1,690 HOURS:490 COSTS(000):$0 Payee Interview; Beneficiary Interview; Custodian Interview FORMS: SSA-835 SSA-836 SSA-837 OMB NO: 0960-0595 EXPIRATION DATE: 11/30/2001 RESPS:133,920 HOURS:1,116 COSTS(000):$0 Electronic Benefit Verification Information FORMS: NONE OMB NO: 0960-0596 EXPIRATION DATE: 06/30/2003 RESPS:21,000 HOURS:525 COSTS(000):$0 Request for Internet Services - Authentication (RISA) FORMS: NONE OMB NO: 0960-0598 EXPIRATION DATE: 01/31/2002 RESPS:100,000 HOURS:50,000 COSTS(000):$0 Work Activity Report (Self-Employed) FORMS: SSA-820-F4 OMB NO: 0960-0602 EXPIRATION DATE: 04/30/2002 RESPS:60,000 HOURS:2,000 COSTS(000):$0 Authorization to Obtain Earnings Data from the Social Security Administration FORMS: SSA-581 OMB NO: 0960-0603 EXPIRATION DATE: 05/31/2001 RESPS:12,000 HOURS:6,000 COSTS(000):$0 Function Report: Adult Function Report, Third Party FORMS: SSA-3373 SSA-3380 OMB NO: 0960-0604 EXPIRATION DATE: 05/31/2001 RESPS:7,500 HOURS:3,125 COSTS(000):$0 Symptoms Report FORMS: SSA-3370 OMB NO: 0960-0605 EXPIRATION DATE: 06/30/2002 RESPS:10,000 HOURS:1,167 COSTS(000):$0 Organization Profile FORMS: NONE OMB NO: 0960-0606 EXPIRATION DATE: 04/30/2003 RESPS:88,000 HOURS:220,074 COSTS(000):$12,194 Annual Registration Statement Identifying Separated Participants with Deferred Vested Benefits FORMS: 1999-EDITION OMB NO: 0960-0607 EXPIRATION DATE: 10/31/2002 RESPS:3,000 HOURS:1,500 COSTS(000):$0 Request for Information FORMS: NONE OMB NO: 0960-0608 EXPIRATION DATE: 08/31/2001 RESPS:130,000 HOURS:6,500 COSTS(000):$0 Request for Claimant Conference FORMS: SSA-378 OMB NO: 0960-0609 EXPIRATION DATE: 10/31/2002 RESPS:6,785 HOURS:5,572 COSTS(000):$0 Disability Evaluation Study (National Survey on Health and FORMS: NONE OMB NO: 0960-0610 EXPIRATION DATE: 11/30/2002 RESPS:12,042 HOURS:2,225 COSTS(000):$0 State Partnership Initiative Demonstration Project FORMS: NONE OMB NO: 0960-0612 EXPIRATION DATE: 01/31/2003 RESPS:16,000 HOURS:3,200 COSTS(000):$0 Survey of Adults to Determine Public Understanding of Social Security Programs FORMS: NONE OMB NO: 0960-0613 EXPIRATION DATE: 02/28/2003 RESPS:4,740 HOURS:1,582 COSTS(000):$0 Referral System for Vocational Rehabilitation Providers (RSVP) FORMS: NONE OMB NO: 0960-0614 EXPIRATION DATE: 02/28/2003 RESPS:200 HOURS:33 COSTS(000):$0 Worker's Compensation Letter; Worker's Compensation Questionnaire FORMS: SSA-L1708 SSA-1708 OMB NO: 0960-0615 EXPIRATION DATE: 06/30/2003 RESPS:12,000 HOURS:4,000 COSTS(000):$0 Application for Special Benefits for World War II Veterans FORMS: SSA-2000 OMB NO: 0960-0616 EXPIRATION DATE: 05/31/2003 RESPS:202 HOURS:1,215 COSTS(000):$0 Notice of Proposed Rulemaking, 20 CFR Part 435, Uniform Administrative Requirements for Grants and Agreements FORMS: NONE OMB NO: 0960-0617 EXPIRATION DATE: 06/30/2003 RESPS:1,000 HOURS:17 COSTS(000):$0 Denial of Supplemental Security Income Benefits for Fugitive Felons and Probation and Parole Violators FORMS: NONE OMB NO: 0960-0618 EXPIRATION DATE: 06/30/2003 RESPS:139,308 HOURS:46,436 COSTS(000):$0 Internet Retirement Insurance Benefit (IRIB) Application FORMS: NONE OMB NO: 0960-0619 EXPIRATION DATE: 09/30/2003 RESPS:40 HOURS:20 COSTS(000):$0 Testimony by Employees and the Production of Records and Information in Legal Proceedings FORMS: NONE OMB NO: 0960-0620 EXPIRATION DATE: 06/30/2001 RESPS:2,000 HOURS:333 COSTS(000):$0 Advance Notice of Termination of Child's Benefits, and Student's Statement Regarding School Attendance FORMS: SSA-1372-TEST OMB NO: 0960-0621 EXPIRATION DATE: 12/31/2003 RESPS:200 HOURS:33 COSTS(000):$0 Representative Payee Report-Special Veterans FORMS: SSA-2001 OMB NO: 0960-0622 EXPIRATION DATE: 09/30/2003 RESPS:1,455,000 HOURS:194,000 COSTS(000):$0 Request for Reconsideration FORMS: SSA-561 OMB NO: 0960-0623 EXPIRATION DATE: 11/30/2003 RESPS:15,415,712 HOURS:770,876 COSTS(000):$0 Authorization for Source to Release Information to SSA FORMS: SSA-837 SSA-827-OP1 SSA-827-OP2 OMB NO: 0960-0625 EXPIRATION DATE: 10/31/2001 RESPS:55 HOURS:110 COSTS(000):$0 Electronic Death Registration Survey FORMS: NONE OMB NO: 0960-0626 EXPIRATION DATE: 11/30/2003 RESPS:250,000 HOURS:8,333 COSTS(000):$0 Integrated Registration for Employers and Submitters (IRES) FORMS: NONE OMB NO: 0960-0627 EXPIRATION DATE: 09/30/2003 RESPS:2,226 HOURS:446 COSTS(000):$0 Employment Support Representative Position (ESR): Survey of Beneficiaries and Community Organizations FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3316-0002 EXPIRATION DATE: 09/30/2001 RESPS:2,067 HOURS:3,816 COSTS(000):$0 Power Distributors Monthly and Annual Reports to TVA FORMS: TVA-3957 TVA-4171 OMB NO: 3316-0008 EXPIRATION DATE: 08/31/2003 RESPS:100 HOURS:1,000 COSTS(000):$0 Foreign Line Crossing Data FORMS: TVA-6573 TVA-6593 OMB NO: 3316-0016 EXPIRATION DATE: 08/31/2003 RESPS:150 HOURS:40 COSTS(000):$0 Farmer Questionnaire - Vicinity of Nuclear Power Plants FORMS: 9476 OMB NO: 3316-0060 EXPIRATION DATE: 05/31/2002 RESPS:2,600 HOURS:3,900 COSTS(000):$0 Application for Section 26a Permit, Tennessee Valley Authority FORMS: NONE OMB NO: 3316-0063 EXPIRATION DATE: 08/31/2003 RESPS:17,583 HOURS:15,913 COSTS(000):$0 Employment Application FORMS: 1 9871 13045 13045A 17353 OMB NO: 3316-0096 EXPIRATION DATE: 08/31/2001 RESPS:1,000 HOURS:50 COSTS(000):$0 Customer Input Card for TVA Recreation Areas FORMS: NONE OMB NO: 3316-0099 EXPIRATION DATE: 10/31/2001 RESPS:2,000 HOURS:400 COSTS(000):$0 TVA Aquatic Plant Management FORMS: NONE OMB NO: 3316-0104 EXPIRATION DATE: 01/31/2002 RESPS:1,700 HOURS:3,400 COSTS(000):$0 Economic Assessment of Waterway Docks and Terminals FORMS: NONE
(RETURN TO AGENCY LIST)No active collections for this agency No active collections for this agency OMB NO: 9000-0001 EXPIRATION DATE: 09/30/2001 RESPS:715 HOURS:286 COSTS(000):$0 Affidavit of Individual Surety -- Standard Form 28; FAR Sections Affected: 28.106-1(e), 28.203(b), 53.228(e) FORMS: SF-28 OMB NO: 9000-0002 EXPIRATION DATE: 10/31/2001 RESPS:800,000 HOURS:464,000 COSTS(000):$0 Solicitation Mailing List Application (SF 129) FORMS: 129 OMB NO: 9000-0004 EXPIRATION DATE: 03/31/2002 RESPS:35,000 HOURS:35,000 COSTS(000):$2,450,000 Architect-Engineer and Related Services Questionnaire -- SF-254, FORMS: SF-254 OMB NO: 9000-0005 EXPIRATION DATE: 04/30/2002 RESPS:20,000 HOURS:24,000 COSTS(000):$1,680,000 Architect-Engineer and Related Services Questionnaire for FORMS: SF-255 OMB NO: 9000-0006 EXPIRATION DATE: 04/30/2001 RESPS:14,631 HOURS:739,389 COSTS(000):$0 Subcontracting Plans/Subcontracting Report for Individual FORMS: SF-294 OMB NO: 9000-0007 EXPIRATION DATE: 09/30/2003 RESPS:7,098 HOURS:90,854 COSTS(000):$0 Summary Subcontract Report FAR Sections Affected: Subpart 19-7, 53.219, SF-295 FORMS: SF-295 OF-312 OMB NO: 9000-0010 EXPIRATION DATE: 09/30/2002 RESPS:864,000 HOURS:318,384 COSTS(000):$19,958 Progress Payments -- SF-1443, FAR Sections Affected: Subpart FORMS: SF-1443 OMB NO: 9000-0011 EXPIRATION DATE: 10/31/2003 RESPS:6,000 HOURS:144,000 COSTS(000):$0 Preaward Survey forms (SFs 1403, 1404, 1405, 1406, 1407, and 1408) FAR Sections Affected: 9.106-2 thru -4 FORMS: SFS-1403 1404 1405 1406 1407 1408 OMB NO: 9000-0012 EXPIRATION DATE: 05/31/2001 RESPS:2,074 HOURS:5,185 COSTS(000):$0 Termination Settlement Proposal Forms -- SFs 1435 through 1440, FAR Sections Affected: Subpart 49.6 FORMS: SF-1435 SF-1436 SF-1437 SF-1438 AF-1439 SF-1440 OMB NO: 9000-0013 EXPIRATION DATE: 11/30/2001 RESPS:199,992 HOURS:10,101,684 COSTS(000):$0 Cost or Pricing Data Exemption Information -- FAR Sections Affected: Subpart 15.4, 42.7, 52.214-28, 52.215-12, 52.215-13, 52.215-20, 52.215-21 FORMS: NONE OMB NO: 9000-0014 EXPIRATION DATE: 04/30/2001 RESPS:21,000 HOURS:3,150 COSTS(000):$0 Statement and Acknowledgment (SF 1413) -- FAR Sections Affected: 22.406-5, 22.407(a), 52.222-11(b), 53.222(e), 53.301-1413 FORMS: SF-1413 OMB NO: 9000-0018 EXPIRATION DATE: 11/30/2001 RESPS:1,285,000 HOURS:12,850 COSTS(000):$0 Certification of Indpependent Price Determination and Parent 3.302 FORMS: NONE OMB NO: 9000-0022 EXPIRATION DATE: 09/30/2001 RESPS:13,300 HOURS:6,650 COSTS(000):$0 Customs and Duties -- FAR Sections Affected: 52.225-10 FORMS: NONE OMB NO: 9000-0023 EXPIRATION DATE: 09/30/2001 RESPS:5 HOURS:1,038 COSTS(000):$0 Balance of Payments Program Certificate -- FAR Sections Affected: 25.305(a), 52.225-6 FORMS: NONE OMB NO: 9000-0024 EXPIRATION DATE: 09/30/2001 RESPS:53,260 HOURS:8,894 COSTS(000):$0 Buy American Certificate -- FAR Sections Affected: 52.225-1 FORMS: NONE OMB NO: 9000-0025 EXPIRATION DATE: 09/30/2001 RESPS:11,400 HOURS:1,904 COSTS(000):$0 Buy American Act, Trade Agreements Act, Balance of Payments Program Ceritficate -- FAR Sections Afected: 52.225-8 FORMS: NONE OMB NO: 9000-0026 EXPIRATION DATE: 03/31/2003 RESPS:157,500 HOURS:26,355 COSTS(000):$555,660 Change Order Accounting - FAR Sections Affected: 43.205(f), FORMS: NONE OMB NO: 9000-0027 EXPIRATION DATE: 09/30/2001 RESPS:1,600 HOURS:48,000 COSTS(000):$0 Value Engineering Requirements -- FAR Sections Affected: Subparts 48.1 and 48.2, 52.248-1, 52.248-2, 52.248-3 FORMS: NONE OMB NO: 9000-0028 EXPIRATION DATE: 12/31/2001 RESPS:2,920 HOURS:11,680 COSTS(000):$0 Termination Requirements -- FAR Sections Affected: Subparts 4.1 thru 49.6 FORMS: NONE OMB NO: 9000-0029 EXPIRATION DATE: 09/30/2001 RESPS:100 HOURS:1,600 COSTS(000):$0 Extraordinary Contractual Action Requests -- FAR Sections Affected: 52.250-1 and 50-403-3 FORMS: NONE OMB NO: 9000-0031 EXPIRATION DATE: 04/30/2002 RESPS:2,100 HOURS:525 COSTS(000):$22,500 Contractor Use of Government Supply Sources -- Subpart 51.1 and FORMS: NONE OMB NO: 9000-0032 EXPIRATION DATE: 04/30/2002 RESPS:140 HOURS:70 COSTS(000):$2,940 Contractor Use of Interagency Motor Pool Vehicles -- Subpart 51-2 FORMS: NONE OMB NO: 9000-0033 EXPIRATION DATE: 09/30/2001 RESPS:1 HOURS:82 COSTS(000):$2,122 Contractor's Signature Authority -- FAR Sections Affected: 4.102 FORMS: NONE OMB NO: 9000-0034 EXPIRATION DATE: 11/30/2003 RESPS:382,840 HOURS:63,934 COSTS(000):$0 Examination of Records by Comptroller General and Contract Audit; 52.215-2; 52.212-5; 52.214-26 FORMS: NONE OMB NO: 9000-0035 EXPIRATION DATE: 03/31/2002 RESPS:13,500 HOURS:13,500 COSTS(000):$567,000 Claims and Appeals -- FAR Sections Affected: Parts 32 and 33 and FORMS: NONE OMB NO: 9000-0037 EXPIRATION DATE: 09/30/2001 RESPS:42,480 HOURS:7,094 COSTS(000):$0 Presolicitation Notice and Response -- Standard Form 1417; FAR Sections Affected: 14.205-4(c), 15.201-c, 36.302, 26.701(a), and 53.236-1(a) FORMS: SF-1417 OMB NO: 9000-0038 EXPIRATION DATE: 03/31/2002 RESPS:4,673 HOURS:2,337 COSTS(000):$98,154 Mistake in Bid -- 14.407 FORMS: NONE OMB NO: 9000-0039 EXPIRATION DATE: 03/31/2002 RESPS:7,989 HOURS:1,254 COSTS(000):$56,028 Descriptive Literature -- 14.202-5 FORMS: NONE OMB NO: 9000-0043 EXPIRATION DATE: 03/31/2002 RESPS:17,200 HOURS:2,872 COSTS(000):$120,624 Delivery Schedules -- FAR Sections Affected: 52.211-8 and FORMS: NONE OMB NO: 9000-0044 EXPIRATION DATE: 04/30/2002 RESPS:12,320 HOURS:209 COSTS(000):$91,980 Bid/Offer Acceptance Period -- 52.214-15, 52.214-16, FORMS: NONE OMB NO: 9000-0045 EXPIRATION DATE: 09/30/2001 RESPS:56,520 HOURS:23,738 COSTS(000):$0 Bid, Performance, and Payment Bonds -- FAR Sections Affected: Subparts 28.1 and 28.2, 52.228-1, 53.228 FORMS: SF-24 SF-25 SF-25-A SF-25-B SF-34 SF-35 SF-273 SF-274 SF-275 SF-1416/SF-1418 OMB NO: 9000-0047 EXPIRATION DATE: 03/31/2002 RESPS:1,111,558 HOURS:77,810 COSTS(000):$3,268,020 Place of Performance -- 14.201-6(b), 15.209(f), 52.214-14, FORMS: NONE OMB NO: 9000-0048 EXPIRATION DATE: 03/31/2002 RESPS:495,000 HOURS:8,415 COSTS(000):$353,430 Authorized Negotiators -- 52.215-11 FORMS: NONE OMB NO: 9000-0053 EXPIRATION DATE: 06/30/2002 RESPS:3,318 HOURS:312 COSTS(000):$13,104 Permits, Authorities, or Franchises Certification -- FAR Sections FORMS: NONE OMB NO: 9000-0054 EXPIRATION DATE: 06/30/2002 RESPS:300 HOURS:75 COSTS(000):$3,150 U.S.-Flag Air Carriers Certification -- FAR Sections Affected: FORMS: NONE OMB NO: 9000-0055 EXPIRATION DATE: 06/30/2002 RESPS:7,920 HOURS:1,323 COSTS(000):$55,566 Freight Classification Description -- FAR Sections Affected: FORMS: NONE OMB NO: 9000-0056 EXPIRATION DATE: 04/30/2002 RESPS:1,000 HOURS:167 COSTS(000):$7,014 Report of Shipment -- 42.1406-1, 42.1406-2, 52.242-12 FORMS: NONE OMB NO: 9000-0057 EXPIRATION DATE: 06/30/2002 RESPS:400 HOURS:100 COSTS(000):$4,200 Evaluation of Export Offers -- FAR Sections Affected: FORMS: NONE OMB NO: 9000-0058 EXPIRATION DATE: 04/30/2002 RESPS:5,200 HOURS:5,200 COSTS(000):$218,400 Schedules for Construction Contracts -- 52.236-15 FORMS: NONE OMB NO: 9000-0059 EXPIRATION DATE: 04/30/2002 RESPS:424 HOURS:72 COSTS(000):$3,024 North Carolina Sales Tax Certification -- FAR Sections Affected: FORMS: NONE OMB NO: 9000-0060 EXPIRATION DATE: 04/30/2002 RESPS:4,212 HOURS:8,424 COSTS(000):$410,670 Accident Prevention Plans and Recordkeeping -- 52.236-13 FORMS: NONE OMB NO: 9000-0061 EXPIRATION DATE: 06/30/2002 RESPS:283,400 HOURS:65,182 COSTS(000):$2,737,644 Transportation Requirements -- FAR Sections Affected: -13; 47.507(a); 52.247-6, -29 thru -44, -48, -52, -57, and -64. FORMS: NONE OMB NO: 9000-0062 EXPIRATION DATE: 04/30/2002 RESPS:4,740 HOURS:1,185 COSTS(000):$41,475 Material and Workmanship -- 52.236-5 FORMS: NONE OMB NO: 9000-0064 EXPIRATION DATE: 04/30/2002 RESPS:50 HOURS:38 COSTS(000):$1,330 Organization and Direction of Work -- 36.519, 52.236-19 FORMS: NONE OMB NO: 9000-0065 EXPIRATION DATE: 03/31/2002 RESPS:1,270 HOURS:318 COSTS(000):$13,356 Overtime -- 22.103 and 52.222-2 FORMS: NONE OMB NO: 9000-0066 EXPIRATION DATE: 03/31/2001 RESPS:5,340 HOURS:2,670 COSTS(000):$0 Professional Employee Compensation Plan -- Subpart 22.11, 52.222-46 FORMS: NONE OMB NO: 9000-0067 EXPIRATION DATE: 04/30/2002 RESPS:3,000 HOURS:3,000 COSTS(000):$131,250 Incentive Contracts -- Subpart 16.4, 52.216-10, 52.216-16, and FORMS: NONE OMB NO: 9000-0068 EXPIRATION DATE: 06/30/2002 RESPS:5,346 HOURS:1,337 COSTS(000):$56,154 Economic Price Adjustment -- FAR Sections Affected: FORMS: NONE OMB NO: 9000-0069 EXPIRATION DATE: 06/30/2002 RESPS:2,469 HOURS:2,469 COSTS(000):$103,698 Indirect Cost Rates -- FAR Sections Affected: Subpart 42.7, FORMS: NONE OMB NO: 9000-0070 EXPIRATION DATE: 06/30/2002 RESPS:9,600,000 HOURS:240,000 COSTS(000):$8,400,000 Payments -- FAR Sections Affected: 52.232-1 Through 52.232-11 FORMS: NONE OMB NO: 9000-0071 EXPIRATION DATE: 06/30/2002 RESPS:7,000 HOURS:7,000 COSTS(000):$294,000 Price Redetermination -- FAR Sections Affected: 16.205, FORMS: NONE OMB NO: 9000-0073 EXPIRATION DATE: 06/30/2002 RESPS:500 HOURS:500 COSTS(000):$17,500 Advance Payments -- FAR Sections Affected: Subpart 32.4 and FORMS: NONE OMB NO: 9000-0074 EXPIRATION DATE: 06/30/2002 RESPS:53,456 HOURS:31,728 COSTS(000):$1,110,480 Limitation of Costs/Funds -- FAR Sections Affected: Subpart 32.7 FORMS: NONE OMB NO: 9000-0075 EXPIRATION DATE: 09/30/2003 RESPS:13,624,122 HOURS:6,575,309 COSTS(000):$0 Government Property - Part 45, Clauses 52.245-2; -4; -5; -7 thru -11; -17 thru 19 FORMS: 1426-THRU-1434 OMB NO: 9000-0076 EXPIRATION DATE: 05/31/2003 RESPS:1,000 HOURS:458 COSTS(000):$0 Novation/Change of Name Requirements FAR Section Affected: Subpart 42.12 FORMS: NONE OMB NO: 9000-0077 EXPIRATION DATE: 06/30/2001 RESPS:950 HOURS:39,719 COSTS(000):$0 Quality Assurance Requirements -- FAR Sections Affected: Subparts 46.1 thru 46.3; 52.246-2 thru 52.246-8; 52.246-10, 52.246-12, and 52.246-15 FORMS: NONE OMB NO: 9000-0078 EXPIRATION DATE: 09/30/2001 RESPS:450 HOURS:3,600 COSTS(000):$0 Make-or-Buy Program -- FAR Sections Affected: 15.407-2, 52.215-9 FORMS: NONE OMB NO: 9000-0079 EXPIRATION DATE: 06/30/2003 RESPS:3,000 HOURS:18,000 COSTS(000):$0 Corporate Aircraft Costs FAR Sections Affected: 31.205-46 FORMS: NONE OMB NO: 9000-0080 EXPIRATION DATE: 09/30/2002 RESPS:10,000 HOURS:10,000 COSTS(000):$420 Integrity of Unit Prices -- FAR Sections Affected: 15.408(f) and FORMS: NONE OMB NO: 9000-0082 EXPIRATION DATE: 09/30/2002 RESPS:38,100 HOURS:31,623 COSTS(000):$1,328 Economic Purchase Quantities--Supplies -- FAR Sections Affected: FORMS: NONE OMB NO: 9000-0083 EXPIRATION DATE: 09/30/2002 RESPS:220,700 HOURS:55,175 COSTS(000):$2,317,350 Qualification Requirements -- FAR Sections Affected: Subpart 9.2 FORMS: NONE OMB NO: 9000-0088 EXPIRATION DATE: 06/30/2001 RESPS:10 HOURS:14,500 COSTS(000):$485,750 Travel Costs -- 31.205-46 FORMS: NONE OMB NO: 9000-0090 EXPIRATION DATE: 03/31/2001 RESPS:1,100 HOURS:29,970 COSTS(000):$0 Rights in Data and Copyrights -- Subpart 27.4, 52.227-14 thru 52.227-21 FORMS: NONE OMB NO: 9000-0091 EXPIRATION DATE: 04/30/2002 RESPS:100 HOURS:100 COSTS(000):$4,200 Anti-Kickback Procedures -- 3.502, 52.203-7 FORMS: NONE OMB NO: 9000-0094 EXPIRATION DATE: 06/30/2002 RESPS:1,100,000 HOURS:91,667 COSTS(000):$3,850,014 Debarment and Suspension -- FAR Sections Affected: 9.409, FORMS: NONE OMB NO: 9000-0095 EXPIRATION DATE: 08/31/2001 RESPS:11,700 HOURS:45,630 COSTS(000):$0 Commerce Patent Regulations -- Public Law 98-620, FAR Subpart 27.3; FAR Sections Affected: Subpart 27.3; 52.227-11; 52.227-12, 52.227-13 FORMS: NONE OMB NO: 9000-0096 EXPIRATION DATE: 09/30/2003 RESPS:30 HOURS:15 COSTS(000):$0 Patents FAR Sections Affected: 27.2; 52.227-2 FORMS: NONE OMB NO: 9000-0097 EXPIRATION DATE: 09/30/2001 RESPS:3,000,000 HOURS:300,000 COSTS(000):$0 Information Reporting to the Internal Revenue Service (Taxpayer Identification Number) -- FAR Sections Affected: Subpart 4.9, 52.204-3 FORMS: NONE OMB NO: 9000-0101 EXPIRATION DATE: 04/30/2002 RESPS:600 HOURS:102 COSTS(000):$8,400 Drug-Free Workplace -- 52.223-6(b)(5) FORMS: NONE OMB NO: 9000-0102 EXPIRATION DATE: 06/30/2001 RESPS:1.5000000 HOURS:697,461 COSTS(000):$0 Prompt Payment -- FAR Sections Affected: Subpart 32.9, 52.232-5, 52..232-25, 52.232-26, 52.232-27, 52.212-4 FORMS: NONE OMB NO: 9000-0107 EXPIRATION DATE: 04/30/2002 RESPS:2,500 HOURS:2,500 COSTS(000):$105,000 Notice of Radioactive Materials -- 23.602 and 52.223-7 FORMS: NONE OMB NO: 9000-0108 EXPIRATION DATE: 04/30/2002 RESPS:1,000 HOURS:1,250 COSTS(000):$52,500 Bankruptcy -- 52.242-13 FORMS: NONE OMB NO: 9000-0113 EXPIRATION DATE: 09/30/2001 RESPS:20 HOURS:20 COSTS(000):$0 Acquisition of Helium FAR Section 8.5 FORMS: NONE OMB NO: 9000-0114 EXPIRATION DATE: 09/30/2003 RESPS:130 HOURS:440 COSTS(000):$30 Right of First Refusal of Employment FAR Sections Affected: FORMS: NONE OMB NO: 9000-0115 EXPIRATION DATE: 11/30/2003 RESPS:100 HOURS:125 COSTS(000):$0 Notification of Ownership Changes FAR Section Affected: 15.408(k); 52.215-19 FORMS: NONE OMB NO: 9000-0122 EXPIRATION DATE: 04/30/2001 RESPS:5,000 HOURS:2,250 COSTS(000):$0 Scope and Duration of Contract -- FAR 52.241-3 FORMS: NONE OMB NO: 9000-0123 EXPIRATION DATE: 04/30/2001 RESPS:5,000 HOURS:2,250 COSTS(000):$0 Change in Rates or Terms and Conditions of Service for Regulated Services -- FAR Sections Affected: 52.241-7 FORMS: NONE OMB NO: 9000-0124 EXPIRATION DATE: 04/30/2001 RESPS:450 HOURS:900 COSTS(000):$0 Capital Credits -- FAR Clause 52.241-13 FORMS: NONE OMB NO: 9000-0125 EXPIRATION DATE: 04/30/2001 RESPS:50 HOURS:25 COSTS(000):$0 Written Refusal of a Utility Supplier to Execute a Utility Contract -- FAR Sections Affected: 41.202(c) FORMS: NONE OMB NO: 9000-0126 EXPIRATION DATE: 04/30/2001 RESPS:500 HOURS:225 COSTS(000):$0 Electric Service Territory Compliance Representation -- FAR 52.241-1 FORMS: NONE OMB NO: 9000-0129 EXPIRATION DATE: 09/30/2003 RESPS:1,462 HOURS:293,650 COSTS(000):$0 Cost Accounting Standards Administration FAR Sections Affected: Subpart 30.6; 52.230-5 FORMS: NONE OMB NO: 9000-0130 EXPIRATION DATE: 03/31/2003 RESPS:5,700 HOURS:952 COSTS(000):$39,318 Buy American Act-north American Free Trade Agreement FAR Sections Affected: 52.225-4 FORMS: NONE OMB NO: 9000-0132 EXPIRATION DATE: 09/30/2003 RESPS:1,580 HOURS:26,860 COSTS(000):$0 Contractors' Purchasing systems Reviews FAR Sections Affected: 44-305-2(c); 44.305-3; 2.244-2(j) FORMS: NONE OMB NO: 9000-0133 EXPIRATION DATE: 11/30/2003 RESPS:18 HOURS:1,800 COSTS(000):$0 Defense Production Act Amendments FAR Sections Affected: 34.1 and 52.234-1 FORMS: NONE OMB NO: 9000-0134 EXPIRATION DATE: 03/31/2001 RESPS:64,350 HOURS:26,800 COSTS(000):$0 Environmentally Sound Products -- FAR 23.405, 52-223-9 FORMS: NONE OMB NO: 9000-0135 EXPIRATION DATE: 03/31/2001 RESPS:60,000 HOURS:30,000 COSTS(000):$0 Subcontractor Requests for Bonds -- FAR 28.106-4 and 52.228-12 FORMS: NONE OMB NO: 9000-0136 EXPIRATION DATE: 12/31/2001 RESPS:1,427,800 HOURS:445,450 COSTS(000):$0 Commercial Item Aquisitions -- FAR Sections Affected: Part 12, 52.212-1 thru 52.212-5 FORMS: NONE OMB NO: 9000-0137 EXPIRATION DATE: 04/30/2001 RESPS:100,000 HOURS:50,000 COSTS(000):$0 Simplified Acquisition Procedures/FACNET -- FAR Sections Affected 4.503 FORMS: NONE OMB NO: 9000-0138 EXPIRATION DATE: 06/30/2001 RESPS:11,000 HOURS:22,000 COSTS(000):$0 Contract Financing -- FAR Sections Affected: Subparts 32.0, 32.1, 32.2, 32.5, 32.10, 52.232-29 thru 32 FORMS: NONE OMB NO: 9000-0139 EXPIRATION DATE: 12/31/2002 RESPS:167,487 HOURS:83,744 COSTS(000):$3,517,248 Federal Acquisition and Community Right-to-Know -- Subpart 23.9, FORMS: NONE OMB NO: 9000-0141 EXPIRATION DATE: 04/30/2002 RESPS:1,000 HOURS:2,500 COSTS(000):$55,000 Buy American Act--Construction (Grimberg Decision) -- FAR FORMS: NONE OMB NO: 9000-0142 EXPIRATION DATE: 08/31/2002 RESPS:600,000 HOURS:1,200,000 COSTS(000):$0 Past Performance Information -- FAR Sections Affected: 9.104-1, 9.105-1, 15.406, 15.604, 15.605, 15.608, 42.302, Subpart 42.15 FORMS: NONE OMB NO: 9000-0144 EXPIRATION DATE: 09/30/2002 RESPS:140,000 HOURS:70,000 COSTS(000):$1,820 Payment by Electronic Fund Transfer -- FAR Sections Affected: FORMS: NONE OMB NO: 9000-0145 EXPIRATION DATE: 03/31/2003 RESPS:201,600 HOURS:4,147 COSTS(000):$106,494 use of data universal numbering system (DuNS) as Primary 52.204-6, 52.212-1)j) FORMS: SF-294 SF-295 OMB NO: 9000-0147 EXPIRATION DATE: 05/31/2003 RESPS:19,500 HOURS:14,500 COSTS(000):$0 Pollution Prevention and Right-to-Know Information FAR Sections Affected: Subpart 23.10 and 52.223-5 FORMS: NONE OMB NO: 9000-0149 EXPIRATION DATE: 07/31/2003 RESPS:15,349 HOURS:13,384 COSTS(000):$0 Subcontract Consent FAR Sections Affected: 44.201, 52.244-2 FORMS: NONE OMB NO: 9000-0150 EXPIRATION DATE: 06/30/2003 RESPS:183,257 HOURS:381,305 COSTS(000):$0 Small Disadvantaged Business Procurement Credit Programs FAR Sections Affected: 19.11 Subpart 19,12, 52.219-22, -23, 52.219-24, 52.219-25, 52.219-26 FORMS: OF-312 OMB NO: 9000-0152 EXPIRATION DATE: 05/31/2003 RESPS:19,906 HOURS:9,953 COSTS(000):$0 Service Contracting - FAR Sections Affected: 52.237-10; 37.115-3 FORMS: NONE OMB NO: 9000-0153 EXPIRATION DATE: 02/28/2002 RESPS:100 HOURS:100 COSTS(000):$2,600 OMB Circular A-119 FORMS: NONE OMB NO: 9000-0154 EXPIRATION DATE: 01/31/2003 RESPS:1 HOURS:81,000 COSTS(000):$2,187 Davis-Bacon Act--Price Adjustment (Actual Method) FORMS: NONE
(RETURN TO AGENCY LIST)OMB NO: 3430-0005 EXPIRATION DATE: 06/30/2002 RESPS:10 HOURS:800 COSTS(000):$0 Application for Cooperative Agreement for the Equipped for the Future (EFF) Field-Based Center for Training, Technical Assistance, and Materials Development FORMS: NONE OMB NO: 3430-0006 EXPIRATION DATE: 06/30/2003 RESPS:25 HOURS:108 COSTS(000):$0 Application for Cooperative Agreement for Content Development Partners (Special Collections) FORMS: NONE OMB NO: 3430-0007 EXPIRATION DATE: 06/30/2003 RESPS:15 HOURS:120 COSTS(000):$0 Application for Cooperative Agreement for LINCS Regional Technology Centers FORMS: NONE
(RETURN TO AGENCY LIST)
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