OMB NO: 0505-0011 EXPIRATION DATE: 07/31/2003
RESPS:600 HOURS:150 COSTS(000):$0
Maximum Workweek - Construction Schedule
FORMS: NONE
OMB NO: 0505-0013 EXPIRATION DATE: 07/31/2003
RESPS:3,200 HOURS:112,000 COSTS(000):$0
Instructions for the Preparation of Technical and Business
Proposals
FORMS: NONE
OMB NO: 0505-0014 EXPIRATION DATE: 07/31/2003
RESPS:45,170 HOURS:4,517 COSTS(000):$0
Brand Name or Equal Provision and Clause
FORMS: NONE
OMB NO: 0518-0024 EXPIRATION DATE: 11/30/2004
RESPS:220 HOURS:53 COSTS(000):$0
Use of facilities or the performance of photography/
cinematography at the U.S. National Arboretum
FORMS: NONE
OMB NO: 0518-0027 EXPIRATION DATE: 02/28/2006
RESPS:3,300 HOURS:725 COSTS(000):$0
Information Collection For Document Delivery Services
FORMS: NONE
OMB NO: 0518-0028 EXPIRATION DATE: 09/30/2003
RESPS:4,360 HOURS:4,601 COSTS(000):$0
Peer Review-Related Forms for the Office of Scientific Quality
Review
FORMS: ARS-199A ARS-200-PA ARS-202PA ARS-203PA ARS-209P ARS-211P
ARS-223P ARS-225P ARS-227P
OMB NO: 0518-0029 EXPIRATION DATE: 08/31/2005
RESPS:200 HOURS:50 COSTS(000):$0
Utilization of Food and Nutrition Information Center (FNIC)
Resources by Personnel at schools receiving USDA funds for Child
Nutrition Programs
FORMS: NONE
OMB NO: 0518-0032 EXPIRATION DATE: 02/28/2006
RESPS:11,450 HOURS:572 COSTS(000):$0
Web Order Forms for Research Data, Materials, Models, and
Publications, Speaker Bureau and Conference, Event, and Study
Registration Services.
FORMS: NONE
OMB NO: 0518-0033 EXPIRATION DATE: 02/28/2006
RESPS:100 HOURS:8 COSTS(000):$0
Meeting the Information Requirements of the Animal Welfare Act
Workshop Registration Form
FORMS: NONE
OMB NO: 0518-0034 EXPIRATION DATE: 06/30/2003
RESPS:288 HOURS:48 COSTS(000):$0
Fluoride Content of the US Tap Water Supply
FORMS: NONE
Cooperative State Research, Education, and Extension Service
OMB NO: 0524-0025 EXPIRATION DATE: 10/31/2004
RESPS:960 HOURS:2,472 COSTS(000):$0
Grant Application Forms for the Small Business Innovation
Research Grants Program
FORMS: CSREES-667 CSREES-668
OMB NO: 0524-0026 EXPIRATION DATE: 08/31/2003
RESPS:150 HOURS:600 COSTS(000):$0
Assurance of Compliance with the Department of Agriculture
Regulations Assuring Civil Rights Compliance "Organizational
Information"
FORMS: CSREES-665 CSREES-666
OMB NO: 0524-0034 EXPIRATION DATE: 03/31/2006
RESPS:60 HOURS:30 COSTS(000):$0
Application for Authorization to Use the 4-H Name and/or Emblem
FORMS: CSREES-01
OMB NO: 0524-0038 EXPIRATION DATE: 04/30/2003
RESPS:117 HOURS:457 COSTS(000):$0
Section 1449 Matching Funds Requirement for Research and
Extension Activities at Eligible Institutions
FORMS: CSREES-2103
OMB NO: 0524-0039 EXPIRATION DATE: 03/31/2006
RESPS:59,550 HOURS:156,813 COSTS(000):$0
Cooperative State Research, Education, and Extension Application
Kit for Research and Extension Programs
FORMS: CSREES-2002 CSREES-2003 CSREES-2004 CSREES-2005 CSREES-2006
CSREES-2007 CSREES-2008 CSREES-2010
OMB NO: 0535-0244 EXPIRATION DATE: 01/31/2004
RESPS:4,874 HOURS:3,229 COSTS(000):$0
Nursery and Greenhouse Production Survey and Nursery and
FORMS: NONE
OMB NO: 0536-0043 EXPIRATION DATE: 09/30/2005
RESPS:57,000 HOURS:7,126 COSTS(000):$0
Food Security Supplement to the Current Population Survey
FORMS: NONE
OMB NO: 0536-0052 EXPIRATION DATE: 03/31/2004
RESPS:1,312 HOURS:729 COSTS(000):$0
The Use of Food Safety Practices in Meat and Poultry
FORMS: NONE
OMB NO: 0536-0053 EXPIRATION DATE: 11/30/2003
RESPS:37,278 HOURS:5,110 COSTS(000):$0
Study of Program Access and Declining Food Stamp Participation
FORMS: NONE
OMB NO: 0551-0015 EXPIRATION DATE: 12/31/2004
RESPS:977 HOURS:4,377 COSTS(000):$0
Sugar imported to be re-exported in refined form, in sugar-
containing products, or used in production of certain polyhydric
alcohols.
FORMS: NONE
OMB NO: 0551-0033 EXPIRATION DATE: 12/31/2005
RESPS:2 HOURS:46 COSTS(000):$0
Emergency Relief from Duty-Free Imports of Perishable Products
under the Andean Trade Promotion and Drug Eradication Act
(ATPDEA)
FORMS: NONE
OMB NO: 0560-0026 EXPIRATION DATE: 09/30/2004
RESPS:4,000 HOURS:6,000 COSTS(000):$0
Application for payment of amounts due persons who have died,
disappeared or have been declared incompetent.
FORMS: FSA-325
OMB NO: 0560-0087 EXPIRATION DATE: 03/31/2005
RESPS:1,858,515 HOURS:552,324 COSTS(000):$0
General Regulations Governing Commodity Loans for 1996 and
Subsequent Crops
FORMS: CCC-64/CCC-601 CCC-638/CCC-665 CCC-666/CCC-677 CCC-679/CCC-685
CCC-699 CCC-681-A CCC-681-1 CCC-678 CCC-6811 CCC-156
OMB NO: 0560-0092 EXPIRATION DATE: 09/30/2004
RESPS:2,131,523 HOURS:2,664,404 COSTS(000):$0
Forms for Participation in a 7-year Production Flexibility
Contract
FORMS: CCC-478 CCC-478B CCC-505
OMB NO: 0560-0096 EXPIRATION DATE: 06/30/2003
RESPS:351,960 HOURS:626,727 COSTS(000):$0
Payment Limitation and Determination of Eligibility of Foreign
Individuals or Entities to Receive Program Benefits
FORMS: CCC-501A CCC-501B CCC-502A CCC-502B CCC-502C CCC-502D CCC-502EZ
CCC-502CONTINUA TION
OMB NO: 0560-0160 EXPIRATION DATE: 03/31/2005
RESPS:200 HOURS:800 COSTS(000):$0
7 CFR 1951-L, Servicing Cases Where Unauthorized Loan or Other
Assistance was Received
FORMS: NONE
OMB NO: 0560-0166 EXPIRATION DATE: 06/30/2005
RESPS:48,312 HOURS:12,078 COSTS(000):$0
Verification of Debts and Assets
FORMS: FSA-440-32
OMB NO: 0560-0167 EXPIRATION DATE: 02/28/2006
RESPS:48,321 HOURS:96,642 COSTS(000):$0
Request for Direct Loan Assistance
FORMS: FSA-410-1
OMB NO: 0560-0170 EXPIRATION DATE: 06/30/2003
RESPS:2,236 HOURS:988 COSTS(000):$0
Disaster Assistance - General (7 CFR Part 1945-A)
FORMS: NONE
OMB NO: 0560-0171 EXPIRATION DATE: 03/31/2005
RESPS:83,050 HOURS:20,531 COSTS(000):$0
Agreement for the Use of Proceeds/Release of Chattel Security
FORMS: 1962-1
OMB NO: 0560-0214 EXPIRATION DATE: 10/31/2004
RESPS:1,000 HOURS:250 COSTS(000):$15,000
Total Quality Systems Audit
FORMS: 1TQ 3TQ
OMB NO: 0560-0215 EXPIRATION DATE: 09/30/2005
RESPS:207,500 HOURS:120,350 COSTS(000):$0
Representations for CCC and FSA Loans and Authorization to File
a Financing Statement
FORMS: CCC-10
OMB NO: 0560-0216 EXPIRATION DATE: 09/30/2005
RESPS:836 HOURS:2,539 COSTS(000):$0
Storage of Honey Forfeited to CCC by Honey Producers
FORMS: CCC-56 56-1 56-2 55
OMB NO: 0570-0022 EXPIRATION DATE: 10/31/2003
RESPS:21,172 HOURS:38,334 COSTS(000):$0
7 CFR 1942-G "Rural Business Enterprise Grants and Television
Demonstration Grants"
FORMS: NONE
OMB NO: 0570-0024 EXPIRATION DATE: 06/30/2004
RESPS:866 HOURS:8,044 COSTS(000):$0
CFR Part 4284-G, Rural Business Opportunity Grants
FORMS: NONE
OMB NO: 0570-0027 EXPIRATION DATE: 04/30/2003
RESPS:8 HOURS:1,382 COSTS(000):$0
Rural Empowerment Zones and Enterprise Communities
FORMS: NONE
OMB NO: 0570-0028 EXPIRATION DATE: 02/29/2004
RESPS:240 HOURS:1,140 COSTS(000):$0
Research on Rural Cooperative Opportunities and Problems
FORMS: NONE
OMB NO: 0570-0039 EXPIRATION DATE: 10/31/2004
RESPS:1,596 HOURS:19,452 COSTS(000):$0
Value-Added Agricultural Product Market Development Grant
Program (Independent Producers)
FORMS: NONE
OMB NO: 0570-0040 EXPIRATION DATE: 06/30/2005
RESPS:48 HOURS:628 COSTS(000):$0
Agricultural Product Market Development Grant Program (Resource
Center)
FORMS: NONE
OMB NO: 0570-0041 EXPIRATION DATE: 03/31/2006
RESPS:297 HOURS:762 COSTS(000):$0
1890 Land Grant Institutions: Rural Entrepreneurial Program
Outreach Initiative
FORMS: NONE
OMB NO: 0570-0042 EXPIRATION DATE: 02/29/2004
RESPS:490 HOURS:113 COSTS(000):$0
Survey of Cooperatives on Selecting Director Candidates for
Director Elections
FORMS: NONE
OMB NO: 0570-0043 EXPIRATION DATE: 04/30/2003
RESPS:50 HOURS:300 COSTS(000):$0
National Rural Development Partnership
FORMS: NONE
OMB NO: 0572-0003 EXPIRATION DATE: 10/31/2005
RESPS:1,422 HOURS:38,394 COSTS(000):$0
Accounting Requirements for RUS Electric and Telecommunications
Borrowers
FORMS: NONE
OMB NO: 0572-0015 EXPIRATION DATE: 03/31/2006
RESPS:10,020 HOURS:14,820 COSTS(000):$0
Advance of Loan Funds and Budgetary Control and Other Related
Burdens
FORMS: RUS-219 RUS-595
OMB NO: 0572-0019 EXPIRATION DATE: 06/30/2003
RESPS:6,750 HOURS:10,125 COSTS(000):$0
Inventory of Work Orders
FORMS: RUS-FORM-219
OMB NO: 0572-0020 EXPIRATION DATE: 04/30/2003
RESPS:5 HOURS:15 COSTS(000):$0
Request for Approval to Sell Capital Assets
FORMS: 369
OMB NO: 0572-0079 EXPIRATION DATE: 09/30/2003
RESPS:406 HOURS:3,621 COSTS(000):$0
Preloan Procedures and Requirements for Telecommunications
Program
FORMS: FORM-490 494 495 507 567 569
OMB NO: 0572-0088 EXPIRATION DATE: 08/31/2003
RESPS:30 HOURS:62 COSTS(000):$0
7 CFR Part 1786, "Prepayment of RUS Guaranteed and Insured Loans
to Electric and Telephone Borrowers"
FORMS: NONE
OMB NO: 0572-0089 EXPIRATION DATE: 01/31/2004
RESPS:110 HOURS:660 COSTS(000):$0
RUS Form 444, "Wholesale Power Contracts"
FORMS: RUS-FORM-444
OMB NO: 0572-0095 EXPIRATION DATE: 04/30/2003
RESPS:3,872 HOURS:20,374 COSTS(000):$0
7 CFR 1773, Policy on Audits of RUS Borrowers
FORMS: NONE
OMB NO: 0572-0096 EXPIRATION DATE: 08/31/2003
RESPS:6,900 HOURS:17,741 COSTS(000):$0
Distance Learning and Telemedicine Loan and Grant Program (7 CFR
1703, Subpart D, E, F and G)
FORMS: NONE
OMB NO: 0572-0097 EXPIRATION DATE: 05/31/2003
RESPS:40 HOURS:140 COSTS(000):$0
7 CFR Part 1703-H, Deferments of RUS Loan Payments for Rural
Development Projects
FORMS: NONE
OMB NO: 0572-0099 EXPIRATION DATE: 10/31/2003
RESPS:1,000 HOURS:750 COSTS(000):$0
7 CFR 1792, Subpart C - Seismic Safety of New Building
Construction
FORMS: NONE
OMB NO: 0572-0100 EXPIRATION DATE: 04/30/2003
RESPS:42 HOURS:69 COSTS(000):$0
Lien Accommodations and Subordinations 7 CFR Part 1717, Subparts
R and S
FORMS: NONE
OMB NO: 0572-0104 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:350 COSTS(000):$0
State Telecommunications Modernization Plan
FORMS: NONE
OMB NO: 0572-0107 EXPIRATION DATE: 10/31/2005
RESPS:3,908 HOURS:85 COSTS(000):$0
7 CFR 1726, Electric System Construction Policies and
Procedures- Electric
FORMS: 168B/168C/187 198/200/213 224/231/238 254/257/307 786/790/792B
830
OMB NO: 0572-0114 EXPIRATION DATE: 04/30/2003
RESPS:142 HOURS:184 COSTS(000):$0
Mergers and Consolidations of Electric Borrowers -- 7 CFR 1717
Subpart D
FORMS: NONE
OMB NO: 0572-0115 EXPIRATION DATE: 04/30/2003
RESPS:6 HOURS:12 COSTS(000):$0
Use of Consultants Funded by Borrowers -- 7 CFR Part 1789
FORMS: NONE
OMB NO: 0572-0116 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:3,000 COSTS(000):$0
7 CFR 1717 Subpart Y, Settlement of Debt Owed by Electric
Borrowers
FORMS: NONE
OMB NO: 0572-0117 EXPIRATION DATE: 03/31/2004
RESPS:1,872 HOURS:450,200 COSTS(000):$0
Environmental Policies and Procedures (7 CFR Part 1794)
FORMS: NONE
OMB NO: 0572-0118 EXPIRATION DATE: 03/31/2006
RESPS:161 HOURS:161 COSTS(000):$0
7 CFR Part 1724, Electric Engineering Architectural Services and
Design Policies and Procedures
FORMS: 211 220 236
OMB NO: 0572-0121 EXPIRATION DATE: 06/30/2003
RESPS:50,650 HOURS:134,240 COSTS(000):$0
7 CFR 1780, Water and Waste Disposal Loan and Grant Program
FORMS: NONE
OMB NO: 0572-0122 EXPIRATION DATE: 01/31/2004
RESPS:110 HOURS:858 COSTS(000):$0
Water and Waste Disposal Programs Guaranteed Loans
FORMS: NONE
OMB NO: 0572-0123 EXPIRATION DATE: 12/31/2004
RESPS:180 HOURS:784 COSTS(000):$0
Extensions of Payments of Principal and Interest
FORMS: NONE
OMB NO: 0572-0124 EXPIRATION DATE: 09/30/2004
RESPS:120 HOURS:345 COSTS(000):$0
Weather Radio Transmitter Grant Program
FORMS: NONE
OMB NO: 0572-0125 EXPIRATION DATE: 06/30/2005
RESPS:30 HOURS:1,005 COSTS(000):$0
Local Dial-Up Internet Grant Program
FORMS: NONE
OMB NO: 0575-0066 EXPIRATION DATE: 04/30/2003
RESPS:158 HOURS:118 COSTS(000):$0
7 CFR 1951-E, "Servicing of Community and Direct Business
Programs Loans and Grants"
FORMS: 1951-15 1951-33
OMB NO: 0575-0172 EXPIRATION DATE: 02/28/2006
RESPS:1,714,622 HOURS:513,872 COSTS(000):$0
7 CFR 3550 - Direct Single Family Housing Loan and Grant
Programs, HB-1-3550, and HB-2-3550
FORMS: NONE
OMB NO: 0575-0173 EXPIRATION DATE: 06/30/2004
RESPS:1,078 HOURS:859 COSTS(000):$0
7 CFR 3570-B, Community Facilities Grant Program
FORMS: FORM-RD-3570-3
OMB NO: 0575-0174 EXPIRATION DATE: 10/31/2005
RESPS:3,005 HOURS:1,581 COSTS(000):$0
7 CFR Part 3565, "Guaranteed Rural Rental Housing Program" and
its supporting handbook
FORMS: 3565-1 3565-2 3565-3 1980-24
OMB NO: 0575-0180 EXPIRATION DATE: 05/31/2004
RESPS:843 HOURS:1,702 COSTS(000):$0
Notice of Funds Availability (NOFA) Inviting Applications for
the Rural Community Development Initiative (RCDI)
FORMS: NONE
OMB NO: 0579-0007 EXPIRATION DATE: 04/30/2003
RESPS:48,135 HOURS:7,451 COSTS(000):$0
National Poultry Improvement Plan (NPIP)
FORMS: VS-9-2 VS-9-3 VS-9-5
OMB NO: 0579-0008 EXPIRATION DATE: 09/30/2005
RESPS:20 HOURS:10 COSTS(000):$0
Application for Inspection and Certification of Animal Byproducts
FORMS: VS-16-24
OMB NO: 0579-0010 EXPIRATION DATE: 02/29/2004
RESPS:35,050 HOURS:1,445 COSTS(000):$0
National Agricultural Pest Information System
FORMS: PPQ-391
OMB NO: 0579-0013 EXPIRATION DATE: 03/31/2005
RESPS:19,472 HOURS:51,177 COSTS(000):$0
Virus-Serum-Toxin Act and Regulations in 9 CFR, Subchapter E,
Parts 101-124
FORMS: 2001 2003 2005 2007 2008 2008A 2015 2020
OMB NO: 0579-0015 EXPIRATION DATE: 03/31/2005
RESPS:51,171 HOURS:17,830 COSTS(000):$0
Importation of Restricted and Controlled Animal and Poultry
Products and Byproducts, Organisms, and Vectors into the US.
FORMS: VS-16-3 VS-16-25 VS-16-26
OMB NO: 0579-0020 EXPIRATION DATE: 08/31/2004
RESPS:42,067 HOURS:21,009 COSTS(000):$0
U.S. Origin Health Certificate
FORMS: VS-17-140
OMB NO: 0579-0142 EXPIRATION DATE: 02/28/2006
RESPS:2,230 HOURS:81 COSTS(000):$0
Importation of Gypsy Moth Host Materials from Canada
FORMS: NONE
OMB NO: 0579-0144 EXPIRATION DATE: 10/31/2005
RESPS:40 HOURS:40 COSTS(000):$0
Importation of Poultry Meat and other Poultry products from
Sinaloa and Sonora, Mexico
FORMS: NONE
OMB NO: 0579-0145 EXPIRATION DATE: 10/31/2005
RESPS:780 HOURS:572 COSTS(000):$0
Poultry and Pork Products Transiting the United States
FORMS: NONE
OMB NO: 0579-0160 EXPIRATION DATE: 01/31/2004
RESPS:100,100 HOURS:5,008 COSTS(000):$0
Commercial Transportation of Equines to Slaughter
FORMS: VS-10-13
OMB NO: 0579-0161 EXPIRATION DATE: 02/29/2004
RESPS:12,000 HOURS:2,600 COSTS(000):$0
Interstate Movement of Swine Within A Production System
FORMS: NONE
OMB NO: 0579-0162 EXPIRATION DATE: 09/30/2004
RESPS:840 HOURS:945 COSTS(000):$0
West Nile Virus Surveillance Report
FORMS: WNV-1 WNV-2
OMB NO: 0579-0163 EXPIRATION DATE: 05/31/2004
RESPS:65 HOURS:15 COSTS(000):$0
Citrus Canker: Commercial citrus tree replacement program
FORMS: PPQ-652
OMB NO: 0579-0165 EXPIRATION DATE: 10/31/2004
RESPS:136 HOURS:34 COSTS(000):$0
Importation of horses, ruminants, swine, and dogs; inspection
and treatment for screwworm
FORMS: NONE
OMB NO: 0579-0166 EXPIRATION DATE: 04/30/2004
RESPS:200 HOURS:40 COSTS(000):$0
District of Columbia Plant Health Certificate
FORMS: PPQ-571
OMB NO: 0579-0167 EXPIRATION DATE: 01/31/2004
RESPS:9,000 HOURS:153 COSTS(000):$0
Veterinary Services User Fees; Fees for Permit Applications
FORMS: NONE
OMB NO: 0579-0168 EXPIRATION DATE: 01/31/2004
RESPS:65 HOURS:10 COSTS(000):$0
Citrus Canker Payments for Recovery of Lost Production
FORMS: NONE
OMB NO: 0579-0169 EXPIRATION DATE: 02/28/2006
RESPS:32 HOURS:16 COSTS(000):$0
Animal Welfare Licensing and Inspection Requirements for Dealers
of Dogs Intended for Hunting, Breeding, or Security Purpose
FORMS: 7001 7001A 7002 7003 7003A 7005 7006
OMB NO: 0579-0170 EXPIRATION DATE: 09/30/2004
RESPS:37 HOURS:37 COSTS(000):$0
West Indian Fruit Fly
FORMS: FORM-540
OMB NO: 0579-0172 EXPIRATION DATE: 03/31/2004
RESPS:40 HOURS:40 COSTS(000):$0
Importation of Mangoes from the Philippines
FORMS: NONE
OMB NO: 0579-0216 EXPIRATION DATE: 08/31/2003
RESPS:108 HOURS:804 COSTS(000):$0
Field Testing of Plants Engineered to Produce Pharmaceutical and
Industrial Compounds
FORMS: 2000
OMB NO: 0579-0220 EXPIRATION DATE: 09/30/2003
RESPS:60,000 HOURS:960 COSTS(000):$0
TB in Cattle and Bison, State Designations; California
FORMS: NONE
Grain Inspection, Packers and Stockyards Administration
OMB NO: 0580-0013 EXPIRATION DATE: 12/31/2004
RESPS:2,494,098 HOURS:396,937 COSTS(000):$0
Reporting and Recordkeeping Requirements (US Grain Standards Act
and Agricultural Marketing Act of 1946)
FORMS: NONE
OMB NO: 0580-0014 EXPIRATION DATE: 02/28/2005
RESPS:4 HOURS:80 COSTS(000):$0
Guidelines for Preparation of Research Proposal
FORMS: NONE
OMB NO: 0580-0015 EXPIRATION DATE: 09/30/2004
RESPS:25,015 HOURS:304,253 COSTS(000):$0
Regulations and Related Reporting and Recordkeeping
Requirements- Packers and Stockyards Programs
FORMS: 116 116-1 1 333 23 315 316 5 131 135
OMB NO: 0580-0016 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:12 COSTS(000):$0
"Clear Title" Regulations to Implement Section 1324 of the Food
Security Act of 1985
FORMS: NONE
OMB NO: 0580-0018 EXPIRATION DATE: 05/31/2003
RESPS:1,874 HOURS:313 COSTS(000):$0
Survey of Customers of the Official Grain Inspection and
Weighing System
FORMS: NONE
OMB NO: 0581-0050 EXPIRATION DATE: 09/30/2005
RESPS:18,720 HOURS:624 COSTS(000):$0
Plan for Estimating Daily Livestock Slaughter Under Federal
Inspection
FORMS: NONE
OMB NO: 0581-0055 EXPIRATION DATE: 04/30/2003
RESPS:1,760 HOURS:1,691 COSTS(000):$0
Application for Plant Variety Protection Certificate and
FORMS: ST-470 ST-470-E
OMB NO: 0581-0056 EXPIRATION DATE: 05/31/2004
RESPS:13,504 HOURS:5,569 COSTS(000):$0
Reporting and Recordkeeping Requirements for 7 CFR, Part 29
FORMS: TB-87 TB-92
OMB NO: 0581-0065 EXPIRATION DATE: 02/29/2004
RESPS:1,323 HOURS:162 COSTS(000):$0
Marketing Order Regulating the Handling of Spearmint Oil
Produced in the Far West, M.O. 985
FORMS: FV-57 FV-58 FV-60 FV-63 FV-63A
OMB NO: 0581-0071 EXPIRATION DATE: 07/31/2005
RESPS:7,446 HOURS:2,445 COSTS(000):$0
Almonds Grown in California
FORMS: FV-176 FV-177 FV-178 FV-179 FV-180
OMB NO: 0581-0093 EXPIRATION DATE: 07/31/2004
RESPS:4,389,973 HOURS:344,801 COSTS(000):$0
National Research, Promotion and Consumer Information Program
(HONEY-FINAL RULE)
FORMS: CV-100 DA-15/19/19-1 20/20-1/ FV-182/229/258 261/265
LS-25/26/26-1 35/45R/46/46-1 48/49/50/81/82 PY-1 MAS-735
OMB NO: 0581-0110 EXPIRATION DATE: 03/31/2006
RESPS:487 HOURS:1,388 COSTS(000):$0
Regulations governing the inspection and grading of manufactured
or processed dairy products -- Recordkeeping
FORMS: NONE
OMB NO: 0581-0113 EXPIRATION DATE: 03/31/2006
RESPS:5,988 HOURS:1,749 COSTS(000):$0
Regulations for Inspection of Eggs
FORMS: PY-76 PY-155 PY-156 PY-222 PY-518-1
OMB NO: 0581-0123 EXPIRATION DATE: 04/30/2005
RESPS:23,347 HOURS:1,292 COSTS(000):$0
Reporting Requirements under the Regulations Governing
Inspection and Certification of Processed Fruits and Vegetables
and Related Products
FORMS: FV-159 FV-356 FV-468
OMB NO: 0581-0124 EXPIRATION DATE: 09/30/2003
RESPS:24,000 HOURS:406 COSTS(000):$0
7 CFR Part 54 - Meats, Prepared Meats, and Meat Products
(Grading, Certification, and Standards)
FORMS: LS-313 LS-315
OMB NO: 0581-0125 EXPIRATION DATE: 02/29/2004
RESPS:212,306 HOURS:6,416 COSTS(000):$0
Regulations Governing Inspection, Certification, and Standards
for Fresh Fruits, Vegetables and Other Products -- 7 CFR 51
FORMS: FV-24 FV-202 FV-237 FV-292
OMB NO: 0581-0126 EXPIRATION DATE: 08/31/2003
RESPS:11,991 HOURS:551 COSTS(000):$0
Reporting Requirements under Regulations Governing the
Inspection and Grading Services of Manufactured or Processed
Dairy Products- FINAL RULE
FORMS: DA-132 DA-155 DA-156 DA-162 DA-201B
OMB NO: 0581-0127 EXPIRATION DATE: 06/30/2004
RESPS:22,978 HOURS:1,781 COSTS(000):$0
7 CFR Part 70, Regulations for Voluntary Grading of Poultry
Products and Rabbit Products
FORMS: PY-32 PY-33 PY-210 PY-212
OMB NO: 0581-0140 EXPIRATION DATE: 05/31/2004
RESPS:1,568 HOURS:392 COSTS(000):$0
Seed Service Program
FORMS: NONE
OMB NO: 0581-0142 EXPIRATION DATE: 09/30/2003
RESPS:10,434 HOURS:2,947 COSTS(000):$0
Olives Grown in California
FORMS: COC-149 COC-150
OMB NO: 0581-0143 EXPIRATION DATE: 05/31/2004
RESPS:445 HOURS:2,204 COSTS(000):$0
Export Fruit Regulations--Export Apple Act (7 CFR Part 33) and
Export Grape and Plum Act (7 CFR Part 35)
FORMS: NONE
OMB NO: 0581-0164 EXPIRATION DATE: 06/30/2005
RESPS:190,407,995 HOURS:1,699,596 COSTS(000):$0
Recordkeeping Requirements for Certified Applicators of
Federally Restricted Use Pesticides (7 CFR Part 110)
FORMS: STD-8 STD-8-1
OMB NO: 0581-0167 EXPIRATION DATE: 05/31/2003
RESPS:9,600 HOURS:1,632 COSTS(000):$0
Specified Commodities Imported into the United States Exempt
from Import Requirements, 7 CFR Parts 944, 980, and 999
FORMS: FV-6 FV-7
OMB NO: 0581-0177 EXPIRATION DATE: 02/29/2004
RESPS:4,649 HOURS:852 COSTS(000):$0
Tart Cherries Grown in the States of Michigan, New York,
Pennsylvania, Oregon, Utah, Washington, and Wisconsin
FORMS: FV-43 FV-43A FV-44 FV-45 FV-45A FV-46 FV-47 FV-48 FV-49
OMB NO: 0581-0189 EXPIRATION DATE: 07/31/2004
RESPS:38,736 HOURS:10,717 COSTS(000):$0
Generic OMB Fruit Crops, Marketing Order Administration Branch
FORMS: FV-304
OMB NO: 0581-0190 EXPIRATION DATE: 02/29/2004
RESPS:13,100 HOURS:3,275 COSTS(000):$0
Pricing Pilot Program
FORMS: Q-P Q-C Q-H
OMB NO: 0581-0191 EXPIRATION DATE: 01/31/2004
RESPS:321,635 HOURS:574,877 COSTS(000):$0
National Organic Program - Final Rule
FORMS: N/A
OMB NO: 0581-0192 EXPIRATION DATE: 07/31/2003
RESPS:18,000 HOURS:3,000 COSTS(000):$0
Federal-State Shipping Point Inspection Program Customer Service
Survey
FORMS: FV-600
OMB NO: 0581-0193 EXPIRATION DATE: 06/30/2003
RESPS:428 HOURS:36 COSTS(000):$0
Customer Service Survey (Meat Grading and Certification
Services).
FORMS: NONE
OMB NO: 0581-0194 EXPIRATION DATE: 06/30/2003
RESPS:109,500 HOURS:11,120 COSTS(000):$0
Pork Promotion, Research, and Consumer Information Program:
Procedures for the Conduct of Referendum
FORMS: NONE
OMB NO: 0581-0197 EXPIRATION DATE: 10/31/2004
RESPS:12,903 HOURS:6,134 COSTS(000):$0
Hass Avocados National Research, Promotion and Consumer
Information Program
FORMS: NONE
OMB NO: 0581-0198 EXPIRATION DATE: 08/31/2004
RESPS:185,178 HOURS:67,601 COSTS(000):$0
Lamb Promotion, Reserarch and Information Program - Final Rule
FORMS: LS-78 LS-81 LS-82 LS-83 LS-84 LS-85 AD-755
OMB NO: 0581-0201 EXPIRATION DATE: 07/31/2005
RESPS:1,443 HOURS:250 COSTS(000):$0
California Prune/Plum Tree Removal Program - Section 32 (as
amended 7 USC 622c) -- Final Rule
FORMS: 298 299
OMB NO: 0581-0202 EXPIRATION DATE: 01/31/2005
RESPS:4,504 HOURS:1,304 COSTS(000):$0
Beef Promotion and Research Act of 1985 - Proposed Rule
FORMS: NONE
OMB NO: 0581-0207 EXPIRATION DATE: 03/31/2006
RESPS:672 HOURS:336 COSTS(000):$0
National Research and Promotion Board, Council, and Committee
Membership Background Information
FORMS: AMS-755 AMS-755-PM
OMB NO: 0581-0208 EXPIRATION DATE: 02/28/2006
RESPS:24 HOURS:6 COSTS(000):$0
Dried Prunes Produced in California - Handler Compensation Survey
FORMS: NONE
OMB NO: 0581-0209 EXPIRATION DATE: 02/28/2006
RESPS:173 HOURS:6 COSTS(000):$0
Mango Promotion, Research, and Information Order
FORMS: NONE
OMB NO: 0581-0210 EXPIRATION DATE: 02/28/2006
RESPS:80 HOURS:4 COSTS(000):$0
AMS Research and Promotion Customer Service Survey
FORMS: AMS-13
OMB NO: 0581-0211 EXPIRATION DATE: 02/28/2006
RESPS:15 HOURS:4 COSTS(000):$0
Dried Prunes Produced in California-Prune Dehydrator Survey
FORMS: NONE
OMB NO: 0583-0092 EXPIRATION DATE: 09/30/2004
RESPS:858 HOURS:119,005 COSTS(000):$0
Marking, Labeling, and Packaging Material
FORMS: FORM-7234-1
OMB NO: 0583-0094 EXPIRATION DATE: 04/30/2003
RESPS:2,201,058 HOURS:168,711 COSTS(000):$0
Exportation, Transportation, and Importation of Meat and Poultry
Products
FORMS: 9060-1 7350-1 9540-1 9510-1
OMB NO: 0583-0103 EXPIRATION DATE: 02/29/2004
RESPS:70,182,657 HOURS:8,559,292 COSTS(000):$243
Pathogen Reduction/Hazard Analysis and Critical Control Point
(HACCP) Systems
FORMS: NONE
OMB NO: 0583-0124 EXPIRATION DATE: 07/31/2003
RESPS:307,500 HOURS:392,100 COSTS(000):$0
E. coli contamination in beef products
FORMS: NONE
OMB NO: 0584-0002 EXPIRATION DATE: 04/30/2003
RESPS:2,976 HOURS:95,232 COSTS(000):$0
Report of School Program Operations
FORMS: FNS-10
OMB NO: 0584-0005 EXPIRATION DATE: 01/31/2006
RESPS:3,368,061 HOURS:702,767 COSTS(000):$0
7 CFR Part 215 - Special Milk Program for Children
FORMS: NONE
OMB NO: 0584-0006 EXPIRATION DATE: 05/31/2004
RESPS:2,210,854 HOURS:9,462,622 COSTS(000):$0
7 CFR Part 210 National School Lunch Program
FORMS: FNS-66 FNS-640 FNS-67
OMB NO: 0584-0008 EXPIRATION DATE: 05/31/2003
RESPS:40,190 HOURS:9,447 COSTS(000):$0
Food Stamp Program - Store Applications
FORMS: FNS-252 FNS-252-2
OMB NO: 0584-0501 EXPIRATION DATE: 05/31/2003
RESPS:800 HOURS:66 COSTS(000):$0
Supplemental Form for Collecting Taxpayer Identifying Numbers
FORMS: FNS-711
OMB NO: 0584-0505 EXPIRATION DATE: 03/31/2004
RESPS:15,942 HOURS:7,817 COSTS(000):$0
Evaluation of the School Breakfast Pilot Program
FORMS: NONE
OMB NO: 0584-0512 EXPIRATION DATE: 05/31/2005
RESPS:505 HOURS:30,000 COSTS(000):$0
Uniform Grant Application for Non-Entitlement Discretionary
Grants
FORMS: FNS-728
OMB NO: 0584-0513 EXPIRATION DATE: 06/30/2003
RESPS:630 HOURS:274 COSTS(000):$0
14 State Summer Food Service Program Pilot Project
FORMS: NONE
OMB NO: 0584-0515 EXPIRATION DATE: 03/31/2004
RESPS:1,113 HOURS:672 COSTS(000):$0
Case Study of NSLP Verification outcomes in large metropplitan
ares
FORMS: NONE
OMB NO: 0584-0516 EXPIRATION DATE: 10/31/2003
RESPS:3,216 HOURS:2,308 COSTS(000):$0
Evaluation of the NSLP Application and Verification and Pilot
Program
FORMS: NONE
OMB NO: 0584-0517 EXPIRATION DATE: 09/30/2003
RESPS:6,186 HOURS:3,532 COSTS(000):$0
Nutrition Education Materials for Food and Nutrition Service
Population Groups
FORMS: NONE
OMB NO: 0596-0009 EXPIRATION DATE: 03/31/2004
RESPS:2,919 HOURS:199 COSTS(000):$0
Residential Fuelwood and Post Assessment, Any State, Year
FORMS: NONE
OMB NO: 0596-0010 EXPIRATION DATE: 06/30/2003
RESPS:2,909 HOURS:2,369 COSTS(000):$0
Forest Industries Data Collection System
FORMS: NONE
OMB NO: 0596-0015 EXPIRATION DATE: 05/31/2003
RESPS:988 HOURS:248 COSTS(000):$0
Airplane Pilot Qualifications and Approval Record, Helicopter
Pilot Qualifications and Approval Record, Airplane Data Record,
and Helicopter Data Record.
FORMS: FS-5700-20 FS-5700-20A FS-5700-21 FS-5700-21A
OMB NO: 0596-0016 EXPIRATION DATE: 07/31/2003
RESPS:2,000 HOURS:500 COSTS(000):$0
Use of Roads by Order
FORMS: FS-7700-40
OMB NO: 0596-0017 EXPIRATION DATE: 04/30/2004
RESPS:20 HOURS:20 COSTS(000):$0
Timber Purchasers' Cost and Sales Data
FORMS: NONE
OMB NO: 0596-0099 EXPIRATION DATE: 12/31/2003
RESPS:6,500 HOURS:1,083 COSTS(000):$0
Application for the Senior Communitry Service Employment Program
FORMS: FS-1800-21B
OMB NO: 0596-0105 EXPIRATION DATE: 06/30/2003
RESPS:200 HOURS:200 COSTS(000):$0
Agreement to Initiate (ATI) and Exchange Agreement (EA)
FORMS: NONE
OMB NO: 0596-0108 EXPIRATION DATE: 04/30/2003
RESPS:1,000 HOURS:416 COSTS(000):$0
Baseline and Trend Information on Wilderness Use and Users
FORMS: NONE
OMB NO: 0596-0110 EXPIRATION DATE: 04/30/2003
RESPS:57,000 HOURS:9,917 COSTS(000):$0
Customer and Use Survey Techniques for Operations, Management,
Evaluation, and Research
FORMS: NONE
OMB NO: 0596-0127 EXPIRATION DATE: 10/31/2003
RESPS:40,000 HOURS:13,333 COSTS(000):$0
National Survey on Recreation and the Environment
FORMS: NONE
OMB NO: 0596-0129 EXPIRATION DATE: 03/31/2006
RESPS:600 HOURS:150 COSTS(000):$0
Day Use on the National Forests of Southern California
FORMS: NONE
OMB NO: 0596-0141 EXPIRATION DATE: 05/31/2005
RESPS:80 HOURS:320 COSTS(000):$0
Small Business Timber Set-Aside Program: Appeal Procedures on
Recompution of Shares
FORMS: NONE
OMB NO: 0596-0146 EXPIRATION DATE: 09/30/2005
RESPS:15,000 HOURS:1,000 COSTS(000):$0
How Are We Doing? Customer Service Comment Card
FORMS: FS-1300-5
OMB NO: 0596-0149 EXPIRATION DATE: 03/31/2004
RESPS:9,250 HOURS:3,043 COSTS(000):$0
Public Information Survey for the Recreation Fee Demonstration
Programs at Sedona, AZ on the Coconino National Forest and the
Pacific Northwest Region
FORMS: NONE
OMB NO: 0596-0158 EXPIRATION DATE: 10/31/2003
RESPS:1,210 HOURS:12,100 COSTS(000):$0
National Forest System Land and Resource Management Planning
FORMS: NONE
OMB NO: 0596-0161 EXPIRATION DATE: 04/30/2004
RESPS:20,000 HOURS:1,667 COSTS(000):$0
Forest Stewarship and Stewardship Incentive Program Participant
Demographics
FORMS: NONE
OMB NO: 0596-0162 EXPIRATION DATE: 08/31/2004
RESPS:1,600 HOURS:800 COSTS(000):$0
Improve Management of the Tongass National Forest and Service to
Southeast Alaska Residents
FORMS: NONE
OMB NO: 0607-0464 EXPIRATION DATE: 08/31/2005
RESPS:57,000 HOURS:4,275 COSTS(000):$0
The 2002 October School Enrollment Supplement to the Current
Population Survey
FORMS: NONE
OMB NO: 0607-0466 EXPIRATION DATE: 09/30/2003
RESPS:48,000 HOURS:1,200 COSTS(000):$0
Current Population Survey (CPS) - November Voting and
Registration Supplement
FORMS: NONE
OMB NO: 0607-0476 EXPIRATION DATE: 09/30/2005
RESPS:11,641 HOURS:10,274 COSTS(000):$0
Current Industrial Reports (CIR) Program (Wave III-Mandatory and
Voluntary)
FORMS: M311H-M311L M311M-M311N M336G-MQ313D MQ313T-MA311D MA315D-MA327E
MA333D-MA333F MA333N MA334P MA334R MA335L
OMB NO: 0607-0700 EXPIRATION DATE: 08/31/2003
RESPS:3,500 HOURS:3,737 COSTS(000):$0
Annual Survey of Local Government Finances, School Systems
FORMS: F-33 F-33-1 F-33-L1 F-33-L2 F-33-L3
OMB NO: 0607-0810 EXPIRATION DATE: 06/30/2005
RESPS:3,063,000 HOURS:1,927,300 COSTS(000):$0
The American Community Survey
FORMS: ACS-1(2003) ACS-1(2003)PR ACS-1(GQ) ACS-3(GQ) ACS-4(GQ) ACS-290
OMB NO: 0607-0875 EXPIRATION DATE: 02/29/2004
RESPS:243,750 HOURS:119,378 COSTS(000):$0
2001 Panel of the Survey of Income and Program Participation,
Wave 8 Topical Modules
FORMS: 21805(L) SIPP/CAPI 21003
OMB NO: 0607-0879 EXPIRATION DATE: 09/30/2003
RESPS:3,000 HOURS:15,600 COSTS(000):$0
Census 2000 Count Question Resolution Program
FORMS: NONE
OMB NO: 0607-0880 EXPIRATION DATE: 06/30/2004
RESPS:480,000 HOURS:720,000 COSTS(000):$0
2002 Economic Census Covering the Wholesale Trade Sector
FORMS: SEE-ATTACHED
OMB NO: 0607-0881 EXPIRATION DATE: 06/30/2004
RESPS:1,615,029 HOURS:1,282,100 COSTS(000):$0
2002 Economic Census Covering the Retail Trade and Accommodation
and Food Services Sectors
FORMS: SEE-ATTACHED
OMB NO: 0607-0882 EXPIRATION DATE: 07/31/2004
RESPS:633,007 HOURS:829,579 COSTS(000):$0
2002 Economic Census Covering Utilities; Transportation and
Warehousing; Finance and Insurance, and Real Estate and Rental
and Leasing Sectors
FORMS: SEE-ATTACHED
OMB NO: 0607-0884 EXPIRATION DATE: 07/31/2004
RESPS:400,000 HOURS:66,666 COSTS(000):$0
2002 Economic Census General Classification Report
FORMS: NC-99023 NC-99023-L-1 NC-99023-L-11 NC-99500
OMB NO: 0607-0886 EXPIRATION DATE: 08/31/2004
RESPS:2,442,300 HOURS:48,846 COSTS(000):$0
2002 Economic Census Ownership or Control Flier
FORMS: SEE-ATTACHED
OMB NO: 0607-0887 EXPIRATION DATE: 09/30/2004
RESPS:1,556,857 HOURS:1,403,061 COSTS(000):$0
2002 Economic Census Covering Information; Professional,
Scientific, and Technical Services; Management of Companies and
Enterprise; Administrative and Support and Waste Management ...
FORMS: SEE-ATTACHED
OMB NO: 0607-0888 EXPIRATION DATE: 09/30/2004
RESPS:90,000 HOURS:22,500 COSTS(000):$0
2002 Census of Governments Local Government Directory Survey
FORMS: G-26 G-28 G-29 G-30 G-32 G-33
OMB NO: 0607-0892 EXPIRATION DATE: 08/31/2004
RESPS:135,300 HOURS:85,170 COSTS(000):$0
2002 Vehicle Inventory and Use Survey
FORMS: TC-9501 TC-9502
OMB NO: 0607-0893 EXPIRATION DATE: 08/31/2004
RESPS:130,000 HOURS:325,000 COSTS(000):$0
2002 Economic Census Covering the Construction Sector
FORMS: CC-23601 CC-23701 CC-23702 CC-23703 CC-23801 CC-23802 CC-23803
CC-23804 CC-23806 CC-23807
OMB NO: 0607-0894 EXPIRATION DATE: 06/30/2004
RESPS:61,500 HOURS:55,750 COSTS(000):$0
2002 Economic Census of Puerto Rico and Island Areas, covering
Puerto Rico, U.S. Virgin Islands, Guam, the Commonwealth of the
Northern Mariana Islands, and American Samoa
FORMS: OA-97120 OA-97220 OA-97123 OA-97223 OA-97130 OA-97230 OA-97142
OA-97242 OA-97144 OA-97244
OMB NO: 0608-0002 EXPIRATION DATE: 07/31/2005
RESPS:1,336 HOURS:3,273 COSTS(000):$0
Institutional Remittances to Foreign Countries (Form BE-40)
FORMS: BE-40
OMB NO: 0608-0004 EXPIRATION DATE: 11/30/2003
RESPS:50,000 HOURS:62,500 COSTS(000):$0
Direct Transactions of U.S. Reporter with Foreign Affiliate
FORMS: BE-577
OMB NO: 0608-0009 EXPIRATION DATE: 12/31/2005
RESPS:15,800 HOURS:19,750 COSTS(000):$0
Transactions of U.S. Affiliate, Except a U.S. Banking Affiliate,
with Foreign Parent (BE-605); and Transactions of U.S. Banking
Affiliate with Foreign Parent (BE-605 Bank)
FORMS: BE-605 BE-605-BANK
OMB NO: 0608-0011 EXPIRATION DATE: 10/31/2004
RESPS:248 HOURS:1,148 COSTS(000):$0
Ocean Freight Revenues and Expenses of United States Carriers
(BE-30) U.S. Airline Operators' Foreign Revenues and Expenses
(BE-37)
FORMS: BE-30 BE-37
OMB NO: 0608-0012 EXPIRATION DATE: 05/31/2004
RESPS:160 HOURS:640 COSTS(000):$0
Foreign Ocean Carriers' Expenses in the United States
FORMS: BE-29
OMB NO: 0608-0013 EXPIRATION DATE: 05/31/2004
RESPS:72 HOURS:360 COSTS(000):$0
Foreign Airline Operators' Revenues and Expenses in the United
States
FORMS: BE-36
OMB NO: 0608-0015 EXPIRATION DATE: 12/31/2004
RESPS:155 HOURS:700 COSTS(000):$0
Annual Survey of Construction, Engineering, Architectural, and
Mining Services Provided by U.S. Firms to Unaffiliated Foreign
Persons
FORMS: BE-47
OMB NO: 0608-0016 EXPIRATION DATE: 10/31/2004
RESPS:325 HOURS:1,300 COSTS(000):$0
Annual Survey of Reinsurance and Other Insurance Transactions by
US Insurance Companies with Foreign Persons
FORMS: 48
OMB NO: 0608-0017 EXPIRATION DATE: 11/30/2003
RESPS:350 HOURS:1,400 COSTS(000):$0
Annual Survey of Royalties, License Fees, and Other Receipts and
Payments for Intangible Rights Between U.S.
FORMS: BE-98
OMB NO: 0608-0034 EXPIRATION DATE: 10/31/2004
RESPS:4,975 HOURS:128,000 COSTS(000):$0
Annual Survey of Foreign Direct Investment in the United States
FORMS: BE-15(LF) BE-15(SF) BE-15(SUPP-C)
OMB NO: 0608-0035 EXPIRATION DATE: 12/31/2003
RESPS:1,200 HOURS:1,800 COSTS(000):$0
Initial Report on a Foreign Person's Direct or Indirect
Acquisition, Establishment, or Purchase of the Operating Assets,
of a U.S. Business Enterprise, Including Real Estate (BE-13); and
FORMS: BE-13 BE-14
OMB NO: 0608-0042 EXPIRATION DATE: 12/31/2005
RESPS:17,700 HOURS:199,500 COSTS(000):$0
Benchmark Survey of Foreign Direct Investment in the United
States - 2002
FORMS: BE-12(LF) BE-12(SF) BE-12-BANK BE-12(X)
OMB NO: 0608-0053 EXPIRATION DATE: 11/30/2003
RESPS:1,500 HOURS:102,600 COSTS(000):$0
Annual Survey of U.S. Direct Investment Abroad (BE-11)
FORMS: BE-11A BE-11B(LF) BE-11B(SF) BE-11C
OMB NO: 0610-0091 EXPIRATION DATE: 03/31/2005
RESPS:193 HOURS:1,544 COSTS(000):$0
Petition by a Firm for Certification of Eligibility to Apply for
Trade Adjustment Assistance
FORMS: ED-840P
OMB NO: 0610-0093 EXPIRATION DATE: 12/31/2005
RESPS:640 HOURS:34,430 COSTS(000):$77
Guidelines for Comprehensive Economic Development Strategy
FORMS: NONE
OMB NO: 0610-0094 EXPIRATION DATE: 02/28/2006
RESPS:1,900 HOURS:48,700 COSTS(000):$104
Proposal for Federal Assistance and Application for Federal
Assistance
FORMS: ED-900P ED-900A ED-900R
OMB NO: 0610-0096 EXPIRATION DATE: 02/28/2006
RESPS:1,160 HOURS:23,200 COSTS(000):$0
Requirements for Approved Construction Investments-Ninth Edition
(Revised)
FORMS: NONE
OMB NO: 0610-0097 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:150 COSTS(000):$1
Award for Excellence in Economic Development
FORMS: NONE
OMB NO: 0610-0098 EXPIRATION DATE: 06/30/2005
RESPS:2,469 HOURS:21,009 COSTS(000):$0
Data Collection for Compliance with Government Performance and
Results Act of 1993 (GPRA)
FORMS: ED-915 ED-916 ED-917 ED-918
OMB NO: 0625-0040 EXPIRATION DATE: 11/30/2005
RESPS:14 HOURS:14 COSTS(000):$0
Application of License to Enter Watches and Watch Movements into
the Customs Territory of the U.S. - Public Law 97-446
FORMS: ITA-334P
OMB NO: 0625-0047 EXPIRATION DATE: 05/31/2005
RESPS:4,000 HOURS:3,000 COSTS(000):$0
Marketing Data Form
FORMS: ITA-466P
OMB NO: 0625-0055 EXPIRATION DATE: 08/31/2004
RESPS:40 HOURS:40 COSTS(000):$0
NATO ICB Bidders List Application
FORMS: ITA-4023P
OMB NO: 0625-0065 EXPIRATION DATE: 07/31/2004
RESPS:60 HOURS:1,644 COSTS(000):$0
Application for the President's "E" and "E Star" Awards for
Export Expansion
FORMS: 725A
OMB NO: 0625-0105 EXPIRATION DATE: 07/31/2005
RESPS:55 HOURS:2,200 COSTS(000):$0
Petition Format for Requesting Relief Under U.S. Antidumping
Duty Law
FORMS: ITA-357P
OMB NO: 0625-0109 EXPIRATION DATE: 12/31/2004
RESPS:150 HOURS:13,352 COSTS(000):$0
Annual Report from Foreign-Trade Zones
FORMS: ITA-359P
OMB NO: 0625-0118 EXPIRATION DATE: 10/31/2004
RESPS:4,560 HOURS:304 COSTS(000):$0
Information on Articles for Physically or Mentally Handicapped
Persons Imported Free of Duty
FORMS: ITA-362P
OMB NO: 0625-0148 EXPIRATION DATE: 12/31/2003
RESPS:5 HOURS:200 COSTS(000):$0
Format for Petition Requesting Relief Under U.S. Countervailing
Duty Law
FORMS: ITA-366P
OMB NO: 0625-0151 EXPIRATION DATE: 12/31/2003
RESPS:5,510 HOURS:1,060 COSTS(000):$0
International Buyer Program: Application and Exhibitor Data
FORMS: 4014P 4102P
OMB NO: 0625-0200 EXPIRATION DATE: 12/31/2005
RESPS:1 HOURS:15 COSTS(000):$0
Antidumping and Countervailing Duties, Procedures for Initiation
of Downstream Product Monitoring
FORMS: 4119P
OMB NO: 0625-0211 EXPIRATION DATE: 07/31/2005
RESPS:384 HOURS:1,152 COSTS(000):$0
U.S.-Japan Semiconductor Agreement Data Collection Program
FORMS: ITA-4115P
OMB NO: 0625-0215 EXPIRATION DATE: 05/31/2005
RESPS:60 HOURS:60 COSTS(000):$0
Certified Trade Mission: Application for Status
FORMS: ITA-4127P
OMB NO: 0625-0224 EXPIRATION DATE: 10/31/2004
RESPS:265 HOURS:465 COSTS(000):$0
American Management and Business Internship Training (AMBIT)
Program: Applications
FORMS: NONE
OMB NO: 0625-0237 EXPIRATION DATE: 12/31/2005
RESPS:9,250 HOURS:1,250 COSTS(000):$0
Export Assistance Center Internet Website Form
FORMS: NONE
OMB NO: 0625-0238 EXPIRATION DATE: 08/31/2003
RESPS:50 HOURS:100 COSTS(000):$0
U.S. Government Trade Information Request
FORMS: ITA-4136P
OMB NO: 0625-0239 EXPIRATION DATE: 05/31/2004
RESPS:1,500 HOURS:550 COSTS(000):$0
Information for Certification Under FAQ 6 of the Safe Harbor
Privacy Principles
FORMS: NONE
OMB NO: 0625-0240 EXPIRATION DATE: 07/31/2004
RESPS:68 HOURS:352 COSTS(000):$0
Imports of Certain Worsted Wool Fabric: Implementation of Tariff
Rate Quotas Established Under Title VI of the Trade and
Development Act of 2000.
FORMS: ITA-4139P ITA-4140P
OMB NO: 0648-0084 EXPIRATION DATE: 07/31/2003
RESPS:604 HOURS:6,476 COSTS(000):$1
Scientific Research, Public Display, and Enhancement Permits
Under the Marine Mammal Protection Act, the Fur Seal Act, and
the Endangered Species Act
FORMS: NONE
OMB NO: 0648-0090 EXPIRATION DATE: 06/30/2004
RESPS:1,000 HOURS:2,250 COSTS(000):$3
Interim Capital Construction Fund Agreement and Certificate
Family of Forms
FORMS: NOAA-FORM-88-14
OMB NO: 0648-0119 EXPIRATION DATE: 11/30/2004
RESPS:195 HOURS:6,598 COSTS(000):$0
Coastal Zone Management Program Administration
FORMS: NONE
OMB NO: 0648-0121 EXPIRATION DATE: 05/31/2004
RESPS:32 HOURS:14,180 COSTS(000):$31
Management and Oversight of the National Estuarine Research
Reserve System
FORMS: NONE
OMB NO: 0648-0135 EXPIRATION DATE: 10/31/2004
RESPS:310 HOURS:985 COSTS(000):$3
Saltonstall-Kennedy Grant Program (S-K Program) Applications and
Reports
FORMS: 88-204 88-205
OMB NO: 0648-0151 EXPIRATION DATE: 03/31/2004
RESPS:78 HOURS:7,512 COSTS(000):$1,673
Applications and Reporting Requirements for Small Takes of
Marine Mammals by Specified Activities Under the Marine Mammal
Protection Act
FORMS: NONE
OMB NO: 0648-0157 EXPIRATION DATE: 05/31/2004
RESPS:390 HOURS:440 COSTS(000):$0
NOAA Space-Based Data Collection System (DCS) Agreements
FORMS: NONE
OMB NO: 0648-0174 EXPIRATION DATE: 03/31/2004
RESPS:67 HOURS:314 COSTS(000):$1
Licensing of Private Land Remote-Sensing Space Systems
FORMS: NONE
OMB NO: 0648-0175 EXPIRATION DATE: 03/31/2005
RESPS:130 HOURS:145 COSTS(000):$0
Marine Fisheries Initiative (MARFIN) Research and Development
Grant and Cooperative Agreement Applications
FORMS: NONE
OMB NO: 0648-0179 EXPIRATION DATE: 12/31/2005
RESPS:51 HOURS:102 COSTS(000):$0
Applications and Reports for Registration as a Tanner or Agent
FORMS: NONE
OMB NO: 0648-0230 EXPIRATION DATE: 03/31/2005
RESPS:24 HOURS:1,048 COSTS(000):$1
Permits for Incidental Taking of Endangered or Threatened Species
FORMS: NONE
OMB NO: 0648-0240 EXPIRATION DATE: 09/30/2005
RESPS:2 HOURS:1 COSTS(000):$0
Application to Shuck Surf Clams/Ocean Quahogs at Sea
FORMS: NONE
OMB NO: 0648-0243 EXPIRATION DATE: 04/30/2005
RESPS:40 HOURS:3 COSTS(000):$0
Survey of Intent and Capacity to Harvest and Process Fish and
Shellfish (Northwest Region)
FORMS: NONE
OMB NO: 0648-0247 EXPIRATION DATE: 04/30/2005
RESPS:12,000 HOURS:360 COSTS(000):$0
Cooperative Game Fish Tagging Report
FORMS: 88-162
OMB NO: 0648-0314 EXPIRATION DATE: 05/31/2003
RESPS:54 HOURS:4,695 COSTS(000):$0
Designation of Fishery Management Council Members and
Application for Reinstatement of State Authority
FORMS: NONE
OMB NO: 0648-0316 EXPIRATION DATE: 03/31/2005
RESPS:6,841 HOURS:733 COSTS(000):$0
Prohibited Species Donation Program
FORMS: NONE
OMB NO: 0648-0318 EXPIRATION DATE: 11/30/2005
RESPS:3,998 HOURS:1,963 COSTS(000):$84
Observer Providers of the North Pacific
FORMS: NONE
OMB NO: 0648-0345 EXPIRATION DATE: 03/31/2005
RESPS:4,926 HOURS:7,500 COSTS(000):$338
Southeast Region Bycatch Reduction Device Certification Family
of Forms
FORMS: NONE
OMB NO: 0648-0346 EXPIRATION DATE: 09/30/2005
RESPS:20 HOURS:30 COSTS(000):$0
List of Gear by Fisheries and Fishery Management Council
FORMS: NONE
OMB NO: 0648-0348 EXPIRATION DATE: 03/31/2005
RESPS:50 HOURS:37 COSTS(000):$1
High Seas Fishing Vessel Identification Requirements
FORMS: NONE
OMB NO: 0648-0349 EXPIRATION DATE: 03/31/2005
RESPS:15,000 HOURS:850 COSTS(000):$2
High Seas Fishing Vessel Reporting Requirements
FORMS: NONE
OMB NO: 0648-0357 EXPIRATION DATE: 09/30/2004
RESPS:1,225 HOURS:21 COSTS(000):$1
Gear-Marking Requirements for the Harbor Porpoise Take Reduction
Plan
FORMS: NONE
OMB NO: 0648-0362 EXPIRATION DATE: 09/30/2004
RESPS:1,611 HOURS:580 COSTS(000):$1
Sea Grant Program Application Requirements for Grants, for John
A. Knauss Marine Policy Fellowships, and for Designation as a
Sea Grant College or Regional Consortia
FORMS: 90-1 90-2 90-4
OMB NO: 0648-0364 EXPIRATION DATE: 09/30/2005
RESPS:257,218 HOURS:2,572 COSTS(000):$27
Gear-Marking Requirements for Atlantic Large Whale Take
Reduction Plan
FORMS: NONE
OMB NO: 0648-0365 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:50 COSTS(000):$0
Documentation of Fish Harvest
FORMS: NONE
OMB NO: 0648-0387 EXPIRATION DATE: 02/28/2006
RESPS:271 HOURS:144 COSTS(000):$1
International Dolphin Conservation Program
FORMS: NONE
OMB NO: 0648-0392 EXPIRATION DATE: 12/31/2005
RESPS:3,010 HOURS:251 COSTS(000):$0
Monitoring of Fish Trap Fishing in the Gulf of Mexico
FORMS: NONE
OMB NO: 0648-0393 EXPIRATION DATE: 09/30/2003
RESPS:141 HOURS:83 COSTS(000):$1
American Fisheries Act: Vessel and Processor Permit Applications
FORMS: NONE
OMB NO: 0648-0397 EXPIRATION DATE: 04/30/2003
RESPS:75 HOURS:75 COSTS(000):$0
Application Form for Membership on a National Marine Sanctuary
Advisory Council
FORMS: NONE
OMB NO: 0648-0400 EXPIRATION DATE: 06/30/2003
RESPS:2,847 HOURS:793 COSTS(000):$0
Commercial Harvesters and Recreational Party and Charter Boat
Socio-cultural and Economic Data Collection Pilot Study
FORMS: NONE
OMB NO: 0648-0401 EXPIRATION DATE: 12/31/2003
RESPS:1,365 HOURS:888 COSTS(000):$0
American Fisheries Act: Recordkeeping and Reporting Requirements
FORMS: NONE
OMB NO: 0648-0402 EXPIRATION DATE: 11/30/2005
RESPS:318 HOURS:6,310 COSTS(000):$4
Application and Reports for Scientific Research and Enhancement
Permits Under the Endangered Species Act
FORMS: NONE
OMB NO: 0648-0420 EXPIRATION DATE: 07/31/2003
RESPS:14 HOURS:31 COSTS(000):$0
Alaska Scallop License Limitation Program Application and
Transfer Forms
FORMS: NONE
OMB NO: 0648-0423 EXPIRATION DATE: 12/31/2003
RESPS:41,410 HOURS:3,451 COSTS(000):$0
An Observer Program for Catcher Vessels in the Pacific Coast
Groundfish Fishery
FORMS: NONE
OMB NO: 0648-0424 EXPIRATION DATE: 02/29/2004
RESPS:207 HOURS:37 COSTS(000):$0
Northeast Region Lobster-Black Sea Bass Area 5 Waiver
Requirements
FORMS: NONE
OMB NO: 0648-0432 EXPIRATION DATE: 08/31/2004
RESPS:2,020 HOURS:3,517 COSTS(000):$3
Dr. Nancy Foster Scholarship Program
FORMS: CD-346
OMB NO: 0648-0433 EXPIRATION DATE: 09/30/2004
RESPS:40 HOURS:10 COSTS(000):$0
Reporting Requirements for the Ocean Salmon Fishery off the
Coasts of Washington, Oregon, and California
FORMS: NONE
OMB NO: 0648-0435 EXPIRATION DATE: 12/31/2005
RESPS:787 HOURS:316 COSTS(000):$0
Survey to Measure Effectiveness of Community-Oriented Policing
for ESA Enforcement
FORMS: NONE
OMB NO: 0648-0439 EXPIRATION DATE: 07/31/2004
RESPS:435 HOURS:154 COSTS(000):$0
North Carolina and Louisiana Commerical King and/or Spanish
Mackerel Fishermen Pilot Economic Survey
FORMS: NONE
OMB NO: 0648-0449 EXPIRATION DATE: 03/31/2005
RESPS:1,000 HOURS:5,000 COSTS(000):$0
Data Collection on Marine Protected and Managed Areas
FORMS: NONE
OMB NO: 0648-0450 EXPIRATION DATE: 03/31/2005
RESPS:2,041 HOURS:1,097 COSTS(000):$8
American Lobster Requirements for Historical Participation in
Areas 3, 4, and 5
FORMS: NONE
OMB NO: 0648-0458 EXPIRATION DATE: 07/31/2005
RESPS:35 HOURS:55 COSTS(000):$7
Southeast Region Stone Crab Vessel Permit Issuance Under the New
Trap Limitation Program
FORMS: NONE
OMB NO: 0648-0459 EXPIRATION DATE: 04/30/2003
RESPS:84 HOURS:1,520 COSTS(000):$1
Coastal and Estuarine Land Conservation, Planning, Protection,
or Restoration
FORMS: NONE
OMB NO: 0648-0460 EXPIRATION DATE: 12/31/2003
RESPS:15,058 HOURS:5,617 COSTS(000):$26
Subsistence Fishery for Pacific Halibut in Waters Off Alaska
FORMS: NONE
OMB NO: 0648-0461 EXPIRATION DATE: 11/30/2005
RESPS:34,151 HOURS:9,029 COSTS(000):$351
South Atlantic Rock Shrimp Vessel Permits and Monitoring
FORMS: NONE
OMB NO: 0648-0462 EXPIRATION DATE: 11/30/2005
RESPS:815 HOURS:382 COSTS(000):$0
Southwest Region Coral Reef Ecosystems Logbook and Reporting
FORMS: NONE
OMB NO: 0648-0463 EXPIRATION DATE: 11/30/2005
RESPS:14 HOURS:30 COSTS(000):$0
Southwest Region Coral Reef Ecosystems Permit Form
FORMS: NONE
OMB NO: 0648-0464 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:150 COSTS(000):$0
Economic Data Collection for the Trap Fishery in the U.S.
Caribbean
FORMS: NONE
OMB NO: 0648-0465 EXPIRATION DATE: 04/30/2003
RESPS:954 HOURS:308 COSTS(000):$0
Revisions to American Lobster Requirements for Historical
Participation in Areas 3, 4, and 5.
FORMS: NONE
OMB NO: 0648-0466 EXPIRATION DATE: 12/31/2005
RESPS:5 HOURS:3,300 COSTS(000):$0
Submission of Conservation Efforts to Make Listings Unnecessary
under the Endangered Species Act
FORMS: NONE
OMB NO: 0648-0468 EXPIRATION DATE: 02/28/2006
RESPS:20 HOURS:40 COSTS(000):$0
Protocol for Access to Tissue Specimen Samples from the National
Marine Mammal Tissue Bank
FORMS: NONE
OMB NO: 0648-0469 EXPIRATION DATE: 02/28/2006
RESPS:144 HOURS:5 COSTS(000):$0
Scup Gear Restricted Area (GRA) Access Program Exemption
Authorization
FORMS: NONE
OMB NO: 0648-0470 EXPIRATION DATE: 02/28/2006
RESPS:441 HOURS:74 COSTS(000):$1
Reporting of Sea Turtle Incidental Take in Virginia Chesapeake
Bay Pound Net Operations
FORMS: NONE
OMB NO: 0648-0471 EXPIRATION DATE: 02/28/2006
RESPS:1,040 HOURS:141 COSTS(000):$6
Highly Migratory Species Scientific Research Permits, Exempted
Fishing Permits, and Letters of Authorization
FORMS: NONE
OMB NO: 0651-0009 EXPIRATION DATE: 06/30/2005
RESPS:677,151 HOURS:144,587 COSTS(000):$147,135
TRADEMARK PROCESSING (Proposed rulemaking, Processing Fee for
Use of Paper Forms for Submission of Applications for
Registration and Other Documents)
FORMS: 4.8/4.9/4.16 1478(A) 1553 1581 1583 1963 2000 PTOTM/4.16/1583
OMB NO: 0651-0012 EXPIRATION DATE: 04/30/2003
RESPS:15,200 HOURS:6,138 COSTS(000):$0
Admittance To Practice and Roster of Registered Patent Attorneys
Office
FORMS: PTO-158 PTO-158A PTO-275 PTO-107A
OMB NO: 0651-0017 EXPIRATION DATE: 07/31/2003
RESPS:330 HOURS:2,270 COSTS(000):$0
Practitioner records maintenance and disclosure before the
patent and trademark office
FORMS: NONE
OMB NO: 0651-0041 EXPIRATION DATE: 06/30/2005
RESPS:11,928 HOURS:1,397 COSTS(000):$4
Public User ID Badging (formerly Public Search Room Badging)
FORMS: PTO-2030
OMB NO: 0651-0042 EXPIRATION DATE: 09/30/2005
RESPS:5,000 HOURS:2,500 COSTS(000):$2
Electronic Application for Patent Examiners-Job Application
Rating System (JARS)
FORMS: PTO_2041
OMB NO: 0651-0043 EXPIRATION DATE: 02/28/2006
RESPS:327,308 HOURS:29,497 COSTS(000):$8
Payment of Patent and Trademark Office Fees by Credit Card
FORMS: PTO-2038
OMB NO: 0693-0031 EXPIRATION DATE: 12/31/2005
RESPS:6,000 HOURS:3,500 COSTS(000):$0
National Institute of Standards and Technology Three-Year
Generic Request for Customer Service-Related Data Collection
FORMS: NONE
OMB NO: 0693-0034 EXPIRATION DATE: 05/31/2003
RESPS:30 HOURS:120 COSTS(000):$0
Evaluation of the Common Industry Format (CIF) for Reporting the
Results of Usability Tests
FORMS: NONE
OMB NO: 0693-0035 EXPIRATION DATE: 05/31/2003
RESPS:1,440 HOURS:120 COSTS(000):$0
User Evaluation of DARPA Communicator systems
FORMS: NONE
OMB NO: 0694-0009 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Approval of Triangular Transactions Involving Commodities
Covered By A U.S. Import Certificate
FORMS: NONE
OMB NO: 0694-0012 EXPIRATION DATE: 07/31/2004
RESPS:1,177 HOURS:1,298 COSTS(000):$0
Report of Requests for Restrictive Trade Practice or Boycott--
Single or Multiple Transactions
FORMS: BXA-621P BXA-6051P
OMB NO: 0694-0013 EXPIRATION DATE: 03/31/2005
RESPS:80 HOURS:43 COSTS(000):$0
Computers and Related Equipment
FORMS: NONE
OMB NO: 0694-0021 EXPIRATION DATE: 02/28/2006
RESPS:3,594 HOURS:959 COSTS(000):$0
Statement by Ultimate Consignee and Purchaser
FORMS: 711
OMB NO: 0694-0023 EXPIRATION DATE: 08/31/2004
RESPS:200 HOURS:104 COSTS(000):$0
Written Assurances for Exports of Technical Data Under License
Exception TSR
FORMS: NONE
OMB NO: 0694-0025 EXPIRATION DATE: 04/30/2004
RESPS:35 HOURS:35 COSTS(000):$0
Short Supply Regulations - Unprocessed Western Red Cedar
FORMS: NONE
OMB NO: 0694-0092 EXPIRATION DATE: 10/31/2004
RESPS:700,000 HOURS:21,963 COSTS(000):$0
Procedures for Acceptance or Rejection of Rated Order
FORMS: NONE
OMB NO: 0694-0104 EXPIRATION DATE: 04/30/2003
RESPS:234 HOURS:1,372 COSTS(000):$0
Commercial Encryption Items under the Jurisdiction of the
FORMS: BXA-748P
OMB NO: 0694-0106 EXPIRATION DATE: 07/31/2004
RESPS:3,050 HOURS:559 COSTS(000):$0
Reporting and Recordkeeping Requirements under the Wassenaar
Arrangement
FORMS: NONE
OMB NO: 0694-0117 EXPIRATION DATE: 04/30/2003
RESPS:356 HOURS:176 COSTS(000):$0
Chemical Weapons Convention, Amendment to the Export
Administration Regulation (End-Use Certificates and Advance
Notifications and Annual Reports)
FORMS: NONE
OMB NO: 0694-0119 EXPIRATION DATE: 09/30/2005
RESPS:6,000 HOURS:24,000 COSTS(000):$0
National Security and Critical Technology Assessments of the US
Industrial Base
FORMS: NONE
OMB NO: 0694-0120 EXPIRATION DATE: 12/31/2005
RESPS:1 HOURS:3,000 COSTS(000):$0
Procedure to initiate an Investigation Under the Trade Expansion
Act of 1962
FORMS: NONE
OMB NO: 0701-0001 EXPIRATION DATE: 10/31/2003
RESPS:2,900 HOURS:8,700 COSTS(000):$0
Application for Training Leading to a Commission in the United
States Air Force
FORMS: AF-56
OMB NO: 0701-0026 EXPIRATION DATE: 09/30/2004
RESPS:16,200 HOURS:8,100 COSTS(000):$0
Nomination for Appointment to the United States Military
Academy, Naval Academy, and Air Force Academy
FORMS: DD-1870
OMB NO: 0701-0063 EXPIRATION DATE: 01/31/2004
RESPS:7,010 HOURS:5,258 COSTS(000):$0
Air Force Academy Candidate Activities Record
FORMS: USAF-147
OMB NO: 0701-0064 EXPIRATION DATE: 01/31/2004
RESPS:7,233 HOURS:3,617 COSTS(000):$0
Air Force Academy Candidate Personal Data Record
FORMS: USAFA-146
OMB NO: 0701-0066 EXPIRATION DATE: 02/29/2004
RESPS:6,954 HOURS:3,477 COSTS(000):$0
Air Force Academy Request for Secondary School Transcript
FORMS: USAFA-148
OMB NO: 0701-0070 EXPIRATION DATE: 01/31/2004
RESPS:30,000 HOURS:2,666 COSTS(000):$0
Family Support Center Information
FORMS: AIR-FORCE-2800 AIR-FORCE-2801 AIR-FORCE-2805
OMB NO: 0701-0078 EXPIRATION DATE: 01/31/2004
RESPS:3,600 HOURS:3,600 COSTS(000):$0
Health Professions Accessions Forms
FORMS: AETC-1402 AETC-1437
OMB NO: 0701-0079 EXPIRATION DATE: 12/31/2003
RESPS:110,231 HOURS:69,105 COSTS(000):$0
Non-Prior Service and Prior Service Accessions
FORMS: AETC-1319 AETC-1325 AETC-1419
OMB NO: 0701-0080 EXPIRATION DATE: 01/31/2004
RESPS:1,200 HOURS:1,500 COSTS(000):$0
Air Force Officer Training School (OTS) Accession Forms
FORMS: AETC-1413 AETC-1422
OMB NO: 0701-0087 EXPIRATION DATE: 03/31/2005
RESPS:9,850 HOURS:3,940 COSTS(000):$0
United States Air Force Academy Application
FORMS: USAFA-149
OMB NO: 0701-0096 EXPIRATION DATE: 11/30/2004
RESPS:5,899 HOURS:1,966 COSTS(000):$0
Application for Appointment as Reserve of the Air Force or USAF
Without Component
FORMS: AF-24
OMB NO: 0701-0101 EXPIRATION DATE: 05/31/2004
RESPS:8,000 HOURS:4,000 COSTS(000):$0
Air Force ROTC College Scholarship Application
FORMS: AF-113
OMB NO: 0701-0103 EXPIRATION DATE: 04/30/2004
RESPS:500 HOURS:350 COSTS(000):$0
Air Force ROTC Scholarship Nomination
FORMS: AFOATS-36
OMB NO: 0701-0105 EXPIRATION DATE: 04/30/2004
RESPS:12,000 HOURS:4,000 COSTS(000):$0
Application for Air Force ROTC Membership
FORMS: AFOATS-20
OMB NO: 0701-0114 EXPIRATION DATE: 04/30/2004
RESPS:40 HOURS:20 COSTS(000):$0
Application for Establishment of Air Force Junior ROTC Unit
FORMS: AFOATS-59
OMB NO: 0701-0127 EXPIRATION DATE: 08/31/2003
RESPS:255 HOURS:64 COSTS(000):$0
USAF Museum System Volunteer Application/Registration
FORMS: AF-3569
OMB NO: 0701-0134 EXPIRATION DATE: 07/31/2004
RESPS:144 HOURS:144 COSTS(000):$0
Request for Approval of Foreign Government Employment of Air
Force Members
FORMS: NONE
OMB NO: 0701-0136 EXPIRATION DATE: 08/31/2005
RESPS:500 HOURS:167 COSTS(000):$0
Community College of the Air Force Alumni Survey
FORMS: NONE
OMB NO: 0701-0149 EXPIRATION DATE: 03/31/2005
RESPS:441 HOURS:110 COSTS(000):$0
Air Force Research Laboratory Public Awareness Survey
FORMS: NONE
OMB NO: 0701-0150 EXPIRATION DATE: 10/31/2005
RESPS:1,300,000 HOURS:1,386,413 COSTS(000):$0
Air Force Recruiting Information Support System (AFRISS)
FORMS: NONE
OMB NO: 0702-0021 EXPIRATION DATE: 07/31/2005
RESPS:70 HOURS:70 COSTS(000):$0
Application and Contract for Establishment of a Junior Reserve
Officers' Training Corps United
FORMS: DA-FORM-3126
OMB NO: 0702-0022 EXPIRATION DATE: 10/31/2003
RESPS:441,677 HOURS:70,548 COSTS(000):$0
Tender of Service and Letter of Intent for Personal Property
Household Goods and Unaccompanied Baggage Shipments
FORMS: DD-FORM-619 DD-FORM-619-1
OMB NO: 0702-0027 EXPIRATION DATE: 01/31/2006
RESPS:75,000 HOURS:3,750 COSTS(000):$0
Signature and Tally Record
FORMS: DD-1907
OMB NO: 0702-0073 EXPIRATION DATE: 02/28/2006
RESPS:11,000 HOURS:8,250 COSTS(000):$0
U.S. Army ROTC 4-year College Scholarship Application (for High
School Students)
FORMS: CC-114-R
OMB NO: 0702-0115 EXPIRATION DATE: 12/31/2003
RESPS:2,240 HOURS:784 COSTS(000):$0
Survey of Army Applicants who were Qualified not Enlisted (QNE)
or Those Who Entered the Delayed Entry Program (DEP) But Chose
Not to Enlist
FORMS: NONE
OMB NO: 0702-0116 EXPIRATION DATE: 12/31/2004
RESPS:519 HOURS:218 COSTS(000):$0
West Point Engineering Graduates Surveys
FORMS: NONE
OMB NO: 0702-0117 EXPIRATION DATE: 03/31/2006
RESPS:1,500 HOURS:375 COSTS(000):$0
Evaluation of Army Benefits Center - Civilian (ABC-C) Retirement
System
FORMS: NONE
OMB NO: 0702-0118 EXPIRATION DATE: 03/31/2006
RESPS:2,500 HOURS:292 COSTS(000):$0
Evaluation of Reasons for Non-Acceptance of Department of Army
Civilian Job Offers
FORMS: NONE
OMB NO: 0704-0003 EXPIRATION DATE: 09/30/2003
RESPS:28,000 HOURS:14,000 COSTS(000):$0
Application for Correction of Military Records Under the
Provisions of Title 10, U.S. Code, Section 1552
FORMS: DD-149
OMB NO: 0704-0004 EXPIRATION DATE: 11/30/2003
RESPS:8,000 HOURS:6,000 COSTS(000):$0
Application for the Review of Discharge or Dismissal from the
Armed Forces of the United States
FORMS: DD-293
OMB NO: 0704-0006 EXPIRATION DATE: 11/30/2004
RESPS:100,000 HOURS:8,300 COSTS(000):$0
Request for Verification of Birth
FORMS: DD-372
OMB NO: 0704-0055 EXPIRATION DATE: 10/31/2004
RESPS:610 HOURS:610 COSTS(000):$0
Department of Defense Application for Priority Rating for
Production or Construction Equipment
FORMS: DD-691
OMB NO: 0704-0100 EXPIRATION DATE: 10/31/2004
RESPS:3,000 HOURS:1,500 COSTS(000):$2
Application for Discharge of Member of Survivor of Member of
Group Certified to Have Performed Active Duty with the Armed
Forces of the United States
FORMS: DD-2168
OMB NO: 0704-0125 EXPIRATION DATE: 09/30/2004
RESPS:2,403 HOURS:401 COSTS(000):$0
Post-election Survey of Overseas Citizens, Post-election Survey
of Local Election Officials
FORMS: NONE
OMB NO: 0704-0152 EXPIRATION DATE: 05/31/2003
RESPS:27,000 HOURS:4,500 COSTS(000):$0
DOD Educational Loan Repayment Program (LRP)
FORMS: DD-2475
OMB NO: 0704-0173 EXPIRATION DATE: 09/30/2003
RESPS:510,000 HOURS:170,000 COSTS(000):$0
Record of Military Processing - Armed Forces of the United States
FORMS: 1966
OMB NO: 0704-0187 EXPIRATION DATE: 12/31/2005
RESPS:1,954,238 HOURS:9,870,858 COSTS(000):$0
Information Collection in Support of the DOD Acquisition Process
FORMS: NONE
OMB NO: 0704-0190 EXPIRATION DATE: 02/28/2006
RESPS:797 HOURS:614 COSTS(000):$0
Appointment of Chaplains for the Military Services
FORMS: DD-2741 DD-2088
OMB NO: 0704-0194 EXPIRATION DATE: 06/30/2004
RESPS:6,400 HOURS:9,493 COSTS(000):$0
Department of Defense Security Agreement, Appendage, and
Certificate Pertaining to Foreign Interests
FORMS: DD-441 DD-441-1 SF-328
OMB NO: 0704-0214 EXPIRATION DATE: 09/30/2005
RESPS:53,160 HOURS:765,498 COSTS(000):$0
Defense Federal Acquisition Reguilation Supplement (DFARS) Part
217, Special Contracting Methods, and related provisions and
clauses in DFARS 252.217
FORMS: NONE
OMB NO: 0704-0216 EXPIRATION DATE: 08/31/2003
RESPS:49 HOURS:859 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
228, Bonds and Insurance, and related clauses at 252.228
FORMS: NONE
OMB NO: 0704-0225 EXPIRATION DATE: 08/31/2004
RESPS:22,602 HOURS:13,758 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement Part 204,
Administrative Matters, and related clauses at 252.204
FORMS: DD-2051 DD-2051-1
OMB NO: 0704-0229 EXPIRATION DATE: 03/31/2004
RESPS:223,942 HOURS:374,268 COSTS(000):$0
Defense Federal Acquisition Supplement Part 225, Foreign
Acquisition, and related clauses at Part 252.225.
FORMS: DD-2139
OMB NO: 0704-0231 EXPIRATION DATE: 06/30/2004
RESPS:800 HOURS:400 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
Subpart 237.70, Mortuary Services, DFARS clause 252.237-7011,
Preparation History, and DD Form 2063, Record of Preparation...
FORMS: DD-2063
OMB NO: 0704-0232 EXPIRATION DATE: 08/31/2004
RESPS:141 HOURS:5,350 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
Subpart 215.8, Price Negotiation, and related clauses at 252.215.
FORMS: NONE
OMB NO: 0704-0245 EXPIRATION DATE: 07/31/2004
RESPS:464,682 HOURS:149,874 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
247, Transportation, and related clauses at 252.247
FORMS: NONE
OMB NO: 0704-0246 EXPIRATION DATE: 02/28/2006
RESPS:42,497 HOURS:50,170 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
245, Government Property, related clauses in DFARS 252, and
related forms in DFARS 253
FORMS: DD-FORM-1149 1149C 1342 1419 1637 1639 1640 1662
OMB NO: 0704-0248 EXPIRATION DATE: 10/31/2004
RESPS:7,800,000 HOURS:988,000 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement, Appendix F,
Material Inspection and Receiving Report
FORMS: DD-250 DD-250C DD-250-1
OMB NO: 0704-0250 EXPIRATION DATE: 02/28/2006
RESPS:86,215 HOURS:217,645 COSTS(000):$0
Defense Federal Acquisition Regulation Supplment (DFARS) Part
242, Contract Administration, related clauses in DFARS 252, and
related forms in DFARS 253
FORMS: DD-FORM-1659
OMB NO: 0704-0252 EXPIRATION DATE: 10/31/2004
RESPS:10,500 HOURS:5,250 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement, Use of
Government Sources by Contractors, and related clauses in Part
252
FORMS: NONE
OMB NO: 0704-0253 EXPIRATION DATE: 07/31/2004
RESPS:90 HOURS:1,440 COSTS(000):$0
Subcontracting Policies and Procedures - DOD FAR Supplement Part
244
FORMS: NONE
OMB NO: 0704-0255 EXPIRATION DATE: 10/31/2004
RESPS:2,740 HOURS:276,625 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement Part 236,
Construction and Architect-Engineer Contracts, and Related
Clauses at 252.236
FORMS: NONE
OMB NO: 0704-0259 EXPIRATION DATE: 06/30/2005
RESPS:136 HOURS:552 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
216, Types of Contracts, and related clauses at 252.216
FORMS: NONE
OMB NO: 0704-0261 EXPIRATION DATE: 08/31/2005
RESPS:21,563 HOURS:5,391 COSTS(000):$0
Department of Defense Standard Tender of Freight Services
FORMS: MT-364-R
OMB NO: 0704-0264 EXPIRATION DATE: 06/30/2004
RESPS:2,000 HOURS:833 COSTS(000):$0
Registration for Scientific and Technical Information Services
FORMS: DD-1540
OMB NO: 0704-0267 EXPIRATION DATE: 04/30/2004
RESPS:42,058 HOURS:420,580 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
230, Cost Accounting Standards Administration, and DD Form 1861,
Contract Facilities Capital Cost of Money
FORMS: DD-1861
OMB NO: 0704-0272 EXPIRATION DATE: 08/31/2004
RESPS:14,726 HOURS:9,997 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
Subpart 223, Environment, Conservation, and Occupational Safety;
and Related Clauses at DFARS Part 252
FORMS: NONE
OMB NO: 0704-0286 EXPIRATION DATE: 08/31/2004
RESPS:6,153 HOURS:6,153 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement Part 205,
Publicizing Contract Actions, and DFARS 252.205-7000, Provision
of Information to Cooperative Acreement Holders
FORMS: NONE
OMB NO: 0704-0290 EXPIRATION DATE: 06/30/2003
RESPS:43,000 HOURS:5,547 COSTS(000):$0
Armed Forces Participation in Public Events
FORMS: DD-2535 DD-2536
OMB NO: 0704-0305 EXPIRATION DATE: 09/30/2003
RESPS:3,940 HOURS:4,815 COSTS(000):$0
Telecommunications Service Priority System
FORMS: SF-314 SF-315 SF-317 SF-318 SF-319
OMB NO: 0704-0321 EXPIRATION DATE: 05/31/2003
RESPS:5,160 HOURS:7,740 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
232, contract Financing, and the clause at DFARS 252.232-7002
Progress Payments for Foreign Military Sales Acquisition
FORMS: NONE
OMB NO: 0704-0323 EXPIRATION DATE: 07/31/2003
RESPS:293,401 HOURS:12,030 COSTS(000):$0
Third Party Collection Program (Record of Other Health Insurance)
FORMS: DD-2569
OMB NO: 0704-0324 EXPIRATION DATE: 05/31/2004
RESPS:1,165 HOURS:276 COSTS(000):$0
Department of Defense Public and Community Service (PACS) Program
FORMS: 2581 2581-1
OMB NO: 0704-0328 EXPIRATION DATE: 05/31/2005
RESPS:102,000 HOURS:10,200 COSTS(000):$0
DOD Building Pass Application
FORMS: DD-2249
OMB NO: 0704-0332 EXPIRATION DATE: 03/31/2004
RESPS:393 HOURS:931 COSTS(000):$0
Defense Federal Acquistion Regualtion Supplement (DFARS)
Appendix I - - DOD Pilot Mentor Protege Program
FORMS: NONE
OMB NO: 0704-0336 EXPIRATION DATE: 10/31/2004
RESPS:15,152 HOURS:821,052 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
223.570, Drug-Free Work Force, and DFARS clause 252.223-7004,
Drug-Free Work Force
FORMS: NONE
OMB NO: 0704-0341 EXPIRATION DATE: 10/31/2004
RESPS:1,598 HOURS:1,806 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
239, Acquisition of Information Technology, and associated
clauses at DFARS 252.239-7000 and 252.239-7006
FORMS: NONE
OMB NO: 0704-0347 EXPIRATION DATE: 06/30/2003
RESPS:81 HOURS:7 COSTS(000):$0
Request for Approval for Qualification Training and Approval of
Contractor Flight Crewmember
FORMS: DD-2627 DD-2628
OMB NO: 0704-0357 EXPIRATION DATE: 12/31/2005
RESPS:756 HOURS:126 COSTS(000):$0
Validation of Public or Community Service Employment Performed
by Retired Personnel Retired Under the Temporary Early
Retirement Authority (TERA) for Increased Retirement Compensation
FORMS: 2676
OMB NO: 0704-0359 EXPIRATION DATE: 08/31/2004
RESPS:800 HOURS:800 COSTS(000):$0
Defense Federal Acqusition Regulation Supplement (DFARS) Part
232 Contract Financing, and related clause at DFARS
252.232-7007, Limitation of Government's Obligation
FORMS: NONE
OMB NO: 0704-0364 EXPIRATION DATE: 06/30/2005
RESPS:808 HOURS:202 COSTS(000):$0
Continued Health Care Benefit Program (CHCBP) Application
FORMS: DD-2837
OMB NO: 0704-0366 EXPIRATION DATE: 03/31/2004
RESPS:185 HOURS:1,619 COSTS(000):$0
National Security Education Program (NSEP Grants to Institutions
of Higher Education)
FORMS: DD-2729 DD-2730
OMB NO: 0704-0367 EXPIRATION DATE: 05/31/2004
RESPS:9,314 HOURS:4,657 COSTS(000):$17
Indebtedness of Military Personnel -Involuntary Allotments
FORMS: DD-2653
OMB NO: 0704-0368 EXPIRATION DATE: 03/31/2004
RESPS:600 HOURS:100 COSTS(000):$0
National Security Education Program (Service Agreement Report
for Scholarshi8p and Fellowship Awards)
FORMS: DD-2752 DD-2753
OMB NO: 0704-0369 EXPIRATION DATE: 11/30/2003
RESPS:1,185,005 HOURS:4,320,447 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement Subparts
227.72, Rights in Computer Software and Computer Software
Documentation; and related clauses and provisions at 252.227
FORMS: NONE
OMB NO: 0704-0370 EXPIRATION DATE: 03/31/2005
RESPS:25,120 HOURS:4,127 COSTS(000):$15
Department of Defense Dependents Schools (DoDDS) Overseas
Employment Opportunities for Education
FORMS: DS-5010 DS-5011 DS-5013 DS-5012
OMB NO: 0704-0384 EXPIRATION DATE: 03/31/2006
RESPS:32,164 HOURS:8,041 COSTS(000):$0
DOD Request for Personnel Security Investigations
FORMS: DD-1879
OMB NO: 0704-0386 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:41 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
219, Small Business Programs and Associated Clauses in Part
252.219
FORMS: NONE
OMB NO: 0704-0390 EXPIRATION DATE: 03/31/2005
RESPS:22 HOURS:88 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
229, Taxes, and related clauses at 252.229
FORMS: NONE
OMB NO: 0704-0396 EXPIRATION DATE: 08/31/2003
RESPS:19,000 HOURS:19,000 COSTS(000):$0
Department of Defense Medical Examiniation Review Board Medical
Information Collection Forms
FORMS: DD-2351/-2369 DD-2370/-2372 DD-2374/-2375 DD-2378/-2379
DD-2380/-2381 DD-2382/-2383 DD-2480/-2489 DD-2492/-2632
OMB NO: 0704-0397 EXPIRATION DATE: 02/28/2006
RESPS:440 HOURS:2,120 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS) Part
243, Contract Modification and related clause at DFARS
252.243-7002
FORMS: NONE
OMB NO: 0704-0398 EXPIRATION DATE: 08/31/2004
RESPS:771 HOURS:771 COSTS(000):$0
Substitutions for Military or Federal Specifications and
Standards, Defense Federal Acquisition Regulation Supplement
(DFARS) Section 211.273, and related clause in DFARS 272.211-7005
FORMS: NONE
OMB NO: 0704-0411 EXPIRATION DATE: 05/31/2003
RESPS:16,470 HOURS:7,400 COSTS(000):$2
Exceptional Family Member Program
FORMS: DD-2792
OMB NO: 0704-0412 EXPIRATION DATE: 07/31/2003
RESPS:145 HOURS:435 COSTS(000):$0
Defense Federal Acquisition Regulation Supplement (DFARS)
Appendix I, DOD Pilot Mentor Protege Program Improvements
FORMS: NONE
OMB NO: 0704-0413 EXPIRATION DATE: 08/31/2003
RESPS:850,000 HOURS:135,833 COSTS(000):$0
Medical Screening of Military Personnel
FORMS: DD-2807-1 DD-2807-2
OMB NO: 0704-0415 EXPIRATION DATE: 03/31/2004
RESPS:300,000 HOURS:100,000 COSTS(000):$0
Application for Department of Defense Common Access Card - Deers
Enrollment
FORMS: DD-1172-2
OMB NO: 0704-0416 EXPIRATION DATE: 12/31/2003
RESPS:1,000 HOURS:2,500 COSTS(000):$0
Defense Systems Management College (DSMC) Information Technology
Study
FORMS: NONE
OMB NO: 0704-0417 EXPIRATION DATE: 09/30/2004
RESPS:11,000 HOURS:13,750 COSTS(000):$0
Personnel Security Investigation Projection for Industry Survey
FORMS: DSS-232
OMB NO: 0704-0421 EXPIRATION DATE: 03/31/2005
RESPS:7,275 HOURS:2,001 COSTS(000):$0
Department of Defense Education Activity Customer Satisfaction
Survey for Parents and Students
FORMS: NONE
OMB NO: 0704-0422 EXPIRATION DATE: 04/30/2005
RESPS:1,335 HOURS:334 COSTS(000):$0
2001 Biennial Review of Defense Agencies and DOD Field Activities
FORMS: NONE
OMB NO: 0704-0425 EXPIRATION DATE: 08/31/2003
RESPS:50 HOURS:400 COSTS(000):$0
Application for Department of Defense Impact Aid for Children
with Severe Disabilities
FORMS: SD-816 SD-816C
OMB NO: 0710-0001 EXPIRATION DATE: 11/30/2005
RESPS:214,150 HOURS:17,750 COSTS(000):$0
Corps of Engineers Civil Works Questionnairs - Generic Clearance
FORMS: NONE
OMB NO: 0710-0003 EXPIRATION DATE: 12/31/2004
RESPS:85,500 HOURS:340,000 COSTS(000):$0
Application for a Department of the Army Permit
FORMS: 4345
OMB NO: 0710-0005 EXPIRATION DATE: 09/30/2003
RESPS:5,400 HOURS:2,500 COSTS(000):$0
Record of Arrivals and Departures of Vessels at Marine Terminals.
FORMS: 3926
OMB NO: 0710-0009 EXPIRATION DATE: 10/31/2004
RESPS:2,500 HOURS:2,000 COSTS(000):$0
Description of Vessels, Description of Operations
FORMS: 3931 3932
OMB NO: 0710-0012 EXPIRATION DATE: 08/31/2005
RESPS:60,000 HOURS:15,000 COSTS(000):$0
Customer Service Survey - Regulatory Program US Army Corps of
Engineers
FORMS: ENG-5065
OMB NO: 0730-0010 EXPIRATION DATE: 09/30/2005
RESPS:300 HOURS:120 COSTS(000):$0
Custodianship Certificate to Support Claim on Behalf of Minor
Children of Deceased Members of the Armed Forces
FORMS: DD-2790
OMB NO: 0730-0014 EXPIRATION DATE: 05/31/2004
RESPS:19,440 HOURS:24,300 COSTS(000):$0
Dependency Statements: Parent, Child Born Out of Wedlock,
Incapacitated Child Over Age 21, Full ?Time Student 21-22 Years
of Age, and Ward of a Court
FORMS: DD-137-3 DD-137-4 DD-137-5 DD-137-6 DD-137-7
OMB NO: 0730-0015 EXPIRATION DATE: 04/30/2004
RESPS:10,000 HOURS:833 COSTS(000):$0
Request for Information Regarding Deceased Debtor
FORMS: DD-2840
OMB NO: 0790-0003 EXPIRATION DATE: 09/30/2004
RESPS:150 HOURS:150 COSTS(000):$0
Base Realignment and Closure (BRAC) Military Base Reuse Status
FORMS: DD-2740
OMB NO: 1800-0011 EXPIRATION DATE: 11/30/2003
RESPS:10,000 HOURS:25,120 COSTS(000):$0
Master Plan for Customer Satisfaction Surveys and Focus Groups
FORMS: NONE
OMB NO: 1810-0036 EXPIRATION DATE: 02/28/2005
RESPS:1,061,320 HOURS:531,211 COSTS(000):$0
Applications for Assistance (sections 8002 and 8003) Impact Aid
Program
FORMS: ED-4019
OMB NO: 1810-0054 EXPIRATION DATE: 01/31/2004
RESPS:90 HOURS:2,180 COSTS(000):$0
Application for the High School Equivalency Program (HEP) and
College Assistance Migrant Program (CAMP) (1890-0001)(KA)
FORMS: NONE
OMB NO: 1810-0060 EXPIRATION DATE: 04/30/2005
RESPS:3,052 HOURS:4,224 COSTS(000):$0
Annual Report of Children in State Agency and Locally Operated
Institutions for Neglected and Delinquent Children
FORMS: ED-4376
OMB NO: 1810-0540 EXPIRATION DATE: 05/31/2003
RESPS:30 HOURS:450 COSTS(000):$0
Application for the Even Start Family Literacy Program - Indian
Tribes and Tribal Organizations
FORMS: CFDA#84.258
OMB NO: 1810-0541 EXPIRATION DATE: 04/30/2003
RESPS:60 HOURS:2,700 COSTS(000):$0
Migrant Education Even Start Family Literacy
FORMS: NONE
OMB NO: 1810-0581 EXPIRATION DATE: 05/31/2003
RESPS:33,759 HOURS:2,586,428 COSTS(000):$0
State educational agency local educational agency, and school
data collection and reporting under ESEA, Title I, Part A
FORMS: NONE
OMB NO: 1810-0614 EXPIRATION DATE: 06/30/2003
RESPS:14,452 HOURS:134,768 COSTS(000):$0
consolidated State Performance Report and State Self-Review
FORMS: NONE
OMB NO: 1810-0620 EXPIRATION DATE: 09/30/2005
RESPS:25 HOURS:200 COSTS(000):$0
State Agency Use of Alternative Method to Distribute Title I
Funds to LEAs with Fewer Than 20,000 Total Residents
FORMS: NONE
OMB NO: 1810-0622 EXPIRATION DATE: 09/30/2005
RESPS:52 HOURS:2,080 COSTS(000):$0
SEA Procedures for Adjusting ED-Determined Title I Allocations
to Local Education Agencies (LEAs)
FORMS: NONE
OMB NO: 1810-0646 EXPIRATION DATE: 10/31/2005
RESPS:4,552 HOURS:4,830 COSTS(000):$0
Application Package for the REAP Small, Rural School Achievement
Program (KA)
FORMS: 84.358A
OMB NO: 1810-0648 EXPIRATION DATE: 07/31/2005
RESPS:57 HOURS:3,306 COSTS(000):$0
Application for State Grants for Reading First (KA)
FORMS: CFDA#84.357
OMB NO: 1810-0652 EXPIRATION DATE: 05/31/2005
RESPS:1,500 HOURS:45,000 COSTS(000):$0
Application for Improving Literacy Through School Libraries
Grant Program
FORMS: 84.364
OMB NO: 1810-0653 EXPIRATION DATE: 06/30/2005
RESPS:56 HOURS:112 COSTS(000):$0
State Progress Report - School Renovation, IDEA, and Technology
Grants Program (KA)
FORMS: 84.352A
OMB NO: 1810-0654 EXPIRATION DATE: 10/31/2004
RESPS:932 HOURS:14,332 COSTS(000):$0
Early Reading First Program Federal Register Notice Inviting
Applications, and Application Packet (KA)
FORMS: 84.359
OMB NO: 1810-0662 EXPIRATION DATE: 05/31/2003
RESPS:43 HOURS:19,925 COSTS(000):$0
Migrant Education Program (MEP) Final Regulations Sections
200.83 200.84 and 200.88
FORMS: CFDA-84.011
OMB NO: 1810-0663 EXPIRATION DATE: 01/31/2006
RESPS:51 HOURS:612 COSTS(000):$0
Information on Students Served by McKinney-Vento Homeless
Assistance Act Subgrants
FORMS: CDF#84.196
OMB NO: 1820-0018 EXPIRATION DATE: 08/31/2004
RESPS:1,000 HOURS:40,000 COSTS(000):$0
Application Kit for New Grants Under the Rehabilitation Services
Administration
FORMS: NONE
OMB NO: 1820-0027 EXPIRATION DATE: 11/30/2003
RESPS:1,000 HOURS:20,000 COSTS(000):$0
Applications for Grants under Disability and Rehabilitation
Research (1890-0001)(SC)
FORMS: NONE
OMB NO: 1820-0028 EXPIRATION DATE: 05/31/2003
RESPS:1,200 HOURS:30,000 COSTS(000):$0
Discretionary Grant Application -- Individuals with Disabilities
Education Act
FORMS: NONE
OMB NO: 1820-0030 EXPIRATION DATE: 01/31/2006
RESPS:57 HOURS:570 COSTS(000):$0
State Eligibility Plan Under Part B of the Individuals with
Disabilities Education Act (SC)
FORMS: ED-9055
OMB NO: 1820-0043 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:30,682 COSTS(000):$0
Report of Children with Disabilities Receiving Special Education
under Part B of the Individuals with Disabilites Education Act
(SC)
FORMS: 869-5
OMB NO: 1820-0500 EXPIRATION DATE: 01/31/2004
RESPS:82 HOURS:1,002,050 COSTS(000):$0
State Vocational Rehabilitation Services Program Final Rules
FORMS: ED(RSA)-SPVR
OMB NO: 1820-0508 EXPIRATION DATE: 05/31/2003
RESPS:80 HOURS:4,240 COSTS(000):$0
Final Regulations to Amend CFR, Title 34, Chapter III, Part 361,
by adding a new subpart E, entitled "Evaluation Standards and
Performance Indicators"
FORMS: RSA-911
OMB NO: 1820-0509 EXPIRATION DATE: 02/28/2005
RESPS:75,560 HOURS:15,292 COSTS(000):$0
Lists of Hearing Officers and Mediators
FORMS: NONE
OMB NO: 1820-0514 EXPIRATION DATE: 12/31/2003
RESPS:1,170,000 HOURS:40,667 COSTS(000):$105,000
Application for Free Loan Service of Captioned Media Program
(English and Spanish Version) and Media Response Card (English
and Spanish Version)
FORMS: NONE
OMB NO: 1820-0517 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:272,890 COSTS(000):$0
Part B, Individuals with Disabilities Education Act
Implementation of FAPE Requirements (SC)
FORMS: NONE
OMB NO: 1820-0518 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:7,685 COSTS(000):$0
Personnel Employed to Provide Special Education and Related
Services for Children with Disabilities (SC)
FORMS: NONE
OMB NO: 1820-0520 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:9 COSTS(000):$0
Written Application for the Client Assistance Program
FORMS: NONE
OMB NO: 1820-0521 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:53,244 COSTS(000):$0
Report of Children with Disabilities Exiting Special Education
During the School Year (SC)
FORMS: 869-3
OMB NO: 1820-0527 EXPIRATION DATE: 04/30/2004
RESPS:55 HOURS:3,300 COSTS(000):$0
State Plan for Independent Living and Center for Independent
Living Programs (SC)
FORMS: NONE
OMB NO: 1820-0530 EXPIRATION DATE: 02/29/2004
RESPS:450 HOURS:1,800 COSTS(000):$0
Performance Report - Training Personnel for the Education of
Individuals with Disabilities Education Act (IDEA) (SC)
FORMS: NONE
OMB NO: 1820-0550 EXPIRATION DATE: 04/30/2005
RESPS:56 HOURS:168 COSTS(000):$0
Infants and Toddlers with Disabilities Program (Part C) of the
Individuals with Disabilities Education Act (IDEA)
FORMS: 1-B20-26P
OMB NO: 1820-0556 EXPIRATION DATE: 07/31/2004
RESPS:57 HOURS:5,187 COSTS(000):$0
Report of Early Intervention Services on IFSPs Provided to
Infants, Toddlers and Their Families in Accordance with Part C
and Report of Number and Type of Personnel Employed and........
FORMS: NONE
OMB NO: 1820-0557 EXPIRATION DATE: 07/31/2004
RESPS:57 HOURS:5,472 COSTS(000):$0
Report of Infants and Toddlers Receiving Early Intervention
Services and of Program Settings Where Services are Provided in
Accordance with Part C, and Report on Infants and Toddlers.....
FORMS: NONE
OMB NO: 1820-0563 EXPIRATION DATE: 11/30/2005
RESPS:80 HOURS:160 COSTS(000):$3
Annual Report on Appeals Process (SC)
FORMS: RSA-722
OMB NO: 1820-0572 EXPIRATION DATE: 02/28/2005
RESPS:56 HOURS:2,240 COSTS(000):$0
Annual Progress Reporting form for Assistive Technology Grantees
(SC)
FORMS: NONE
OMB NO: 1820-0578 EXPIRATION DATE: 08/31/2003
RESPS:57 HOURS:1,710 COSTS(000):$0
Annual Performance Report and Report to the Secretary Under the
Infants and Toddlers with Disabilities Proram (Part C, IDEA)
FORMS: NONE
OMB NO: 1820-0599 EXPIRATION DATE: 02/28/2005
RESPS:1,079 HOURS:10,790 COSTS(000):$0
Part B Complaint Procedures (SC)
FORMS: NONE
OMB NO: 1820-0600 EXPIRATION DATE: 02/28/2005
RESPS:28,844 HOURS:28,844 COSTS(000):$0
Local Educational Agency Application Under Part B of the
FORMS: NONE
OMB NO: 1820-0608 EXPIRATION DATE: 03/31/2004
RESPS:55 HOURS:440 COSTS(000):$0
Independent Living Services For Older Individuals Who Are Blind
FORMS: ED(RSA)-7-OB
OMB NO: 1820-0616 EXPIRATION DATE: 12/31/2003
RESPS:6,689 HOURS:5,072 COSTS(000):$0
National Early Intervention Longitudinal Study
FORMS: NONE
OMB NO: 1820-0620 EXPIRATION DATE: 09/30/2005
RESPS:30 HOURS:2,700 COSTS(000):$0
Application for New Grants -- State Program Improvement Grants
for Children with Disabilities
FORMS: NONE
OMB NO: 1820-0621 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:149,350 COSTS(000):$0
Report of Children with Disabilities Unilaterally Removed or
Suspended/Expelled for More Than 10 Days (SC)
FORMS: NONE
OMB NO: 1820-0622 EXPIRATION DATE: 05/31/2005
RESPS:8,000 HOURS:152,500 COSTS(000):$0
Special Education - Personnel Preparation to Improve Services
and Results for Children with Disabilities
FORMS: NONE
OMB NO: 1820-0625 EXPIRATION DATE: 08/31/2005
RESPS:57 HOURS:9 COSTS(000):$0
Protection and Advocacy of Individual Rights (PAIR) Program
Assurances (SC)
FORMS: NONE
OMB NO: 1820-0627 EXPIRATION DATE: 03/31/2006
RESPS:57 HOURS:342 COSTS(000):$0
Annual Protection and Advocacy of Individual Rights (PAIR)
Program Performance Report (SC)
FORMS: RSA-509
OMB NO: 1820-0632 EXPIRATION DATE: 06/30/2003
RESPS:32,138 HOURS:17,049 COSTS(000):$0
Special Education Elementary Longitudinal Study (Seels)
FORMS: NONE
OMB NO: 1820-0633 EXPIRATION DATE: 04/30/2003
RESPS:5,595 HOURS:11,262 COSTS(000):$0
State and Local Implementation of IDEA '97
FORMS: NONE
OMB NO: 1820-0634 EXPIRATION DATE: 10/31/2003
RESPS:57 HOURS:1,680 COSTS(000):$39
Alternative Financing Program and the Alternate Financing
FORMS: NONE
OMB NO: 1820-0636 EXPIRATION DATE: 12/31/2003
RESPS:464 HOURS:684 COSTS(000):$0
Evaluation of the American Indian Vocational Rehabilitation
Services (AIVRS) Program (SC)
FORMS: NONE
OMB NO: 1820-0637 EXPIRATION DATE: 12/31/2003
RESPS:300 HOURS:100 COSTS(000):$0
NIDRR Quality of Research Rating Scale
FORMS: NONE
OMB NO: 1820-0640 EXPIRATION DATE: 03/31/2004
RESPS:1,003 HOURS:1,575 COSTS(000):$0
Evaluation of Independent Living Programs (SC)
FORMS: NONE
OMB NO: 1820-0642 EXPIRATION DATE: 02/29/2004
RESPS:193 HOURS:3,088 COSTS(000):$0
Annual Performance Reporting Forms for NIDRR Grantees (RERCs,
RRTCs, DBTACs, DRRPs, Model Systems, Dissemination &
Utillization Projects) (SC)
FORMS: NONE
OMB NO: 1820-0644 EXPIRATION DATE: 07/31/2004
RESPS:58 HOURS:18,312 COSTS(000):$0
Consolidated Data Collection on Students with Disabilities (SC)
FORMS: NONE
OMB NO: 1820-0646 EXPIRATION DATE: 09/30/2004
RESPS:73 HOURS:2,044 COSTS(000):$0
Annual Progress Reporting Form for Special Demonstration
Programs (SC)
FORMS: NONE
OMB NO: 1820-0649 EXPIRATION DATE: 01/31/2004
RESPS:135 HOURS:333 COSTS(000):$0
An Evaluation of the State Program Improvement Grant (SIG)
Program
FORMS: NONE
OMB NO: 1820-0650 EXPIRATION DATE: 04/30/2005
RESPS:462 HOURS:498 COSTS(000):$0
Evaluation of the Projects With Industry (PWI) Program
FORMS: NONE
OMB NO: 1820-0655 EXPIRATION DATE: 01/31/2005
RESPS:66 HOURS:1,056 COSTS(000):$0
Annual Progress Reporting Form for the American Indian
Vocational Rehabilitation Services (AIVRS) Program
FORMS: NONE
OMB NO: 1830-0537 EXPIRATION DATE: 04/30/2003
RESPS:689 HOURS:669 COSTS(000):$0
National Survey to Determine the Need for Special Education
Services (JM)
FORMS: NONE
OMB NO: 1830-0541 EXPIRATION DATE: 05/31/2003
RESPS:59 HOURS:2,124 COSTS(000):$0
Carl D. Perkins Vocational and Technical Education
Act--Occupational and Employment Information State Grants
(Section 118, PL 105-332) (1890-0001) (SC)
FORMS: CFDA#84.346
OMB NO: 1830-0542 EXPIRATION DATE: 09/30/2003
RESPS:639 HOURS:75,632 COSTS(000):$0
Application for Vocational and Technical Education Direct Grants
(1890-0001) (SC)
FORMS: NONE
OMB NO: 1830-0544 EXPIRATION DATE: 11/30/2003
RESPS:38 HOURS:95 COSTS(000):$0
Indian Vocational Education Program Technology Survey
FORMS: NONE
OMB NO: 1830-0546 EXPIRATION DATE: 11/30/2003
RESPS:11 HOURS:440 COSTS(000):$0
Career Cluster Cooperative Agreements with States
FORMS: NONE
OMB NO: 1830-0548 EXPIRATION DATE: 01/31/2004
RESPS:59 HOURS:4,720 COSTS(000):$0
America's Career Resource Network State Grants Annual
Performance Reports
FORMS: NONE
OMB NO: 1830-0549 EXPIRATION DATE: 02/29/2004
RESPS:1,049 HOURS:831 COSTS(000):$0
New American High Schools Implementation Study
FORMS: NONE
OMB NO: 1840-0005 EXPIRATION DATE: 06/30/2004
RESPS:670 HOURS:12,560 COSTS(000):$0
Fulbright-Hays Training Grants Faculty Research Abroad Program -
CFDA 84.019 Doctoral Dissertation Research Abroad Program - CFDA
84.022
FORMS: NONE
OMB NO: 1840-0007 EXPIRATION DATE: 06/30/2003
RESPS:370 HOURS:30,200 COSTS(000):$0
Grant Application under the Teacher Quality Enhancement Grants,
for the preparation of applications for: Partnership Grants.....
FORMS: NONE
OMB NO: 1840-0017 EXPIRATION DATE: 06/30/2003
RESPS:1,200 HOURS:40,800 COSTS(000):$0
Application for Grants under Student Support Services Program
FORMS: NONE
OMB NO: 1840-0065 EXPIRATION DATE: 06/30/2004
RESPS:1,300 HOURS:44,200 COSTS(000):$0
Application for Grants Under Talent Search and Educational
Opportunity Centers Programs
FORMS: NONE
OMB NO: 1840-0068 EXPIRATION DATE: 06/30/2004
RESPS:528 HOURS:38,550 COSTS(000):$0
Applications for Title VI International Education Programs
FORMS: CFDA-84.153 84.021 84.017 84.016 84.15A 84.15B 84.274 84.229
OMB NO: 1840-0103 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:8,400 COSTS(000):$0
Application for Designation as an Eligible Institution
(1890-0001) for Title III and V
FORMS: 1049
OMB NO: 1840-0109 EXPIRATION DATE: 02/28/2005
RESPS:200 HOURS:8,000 COSTS(000):$0
Application for Grants Under the Minority Science and
Engineering Improvement Program (1890-0001) (JS)
FORMS: NONE
OMB NO: 1840-0113 EXPIRATION DATE: 11/30/2003
RESPS:117 HOURS:889 COSTS(000):$0
Application for Strengthening Historically Black Colleges and
Universities Program and Historically Black Graduate
Institutions Program (JS)
FORMS: ED-852
OMB NO: 1840-0507 EXPIRATION DATE: 08/31/2004
RESPS:25 HOURS:113 COSTS(000):$0
Performance Report for the Training Programs for Federal TRIO
Programs
FORMS: CFDA#84.103
OMB NO: 1840-0514 EXPIRATION DATE: 12/31/2003
RESPS:1,650 HOURS:19,500 COSTS(000):$0
FIPSE Comprehensive Program Grant Application
FORMS: 84.116A=CFDA 84.116B=CFDA
OMB NO: 1840-0525 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:3,060 COSTS(000):$0
Annual Performance Report for the Student Support Services
Program (JS)
FORMS: 84.042A
OMB NO: 1840-0562 EXPIRATION DATE: 04/30/2003
RESPS:2,000 HOURS:10,000 COSTS(000):$0
Application Package for the Jacob K. Javits Fellowship Program
FORMS: NONE
OMB NO: 1840-0564 EXPIRATION DATE: 07/31/2003
RESPS:330 HOURS:990 COSTS(000):$0
Financial Report for the Endowment Challenge Grant Program
FORMS: NONE
OMB NO: 1840-0595 EXPIRATION DATE: 08/31/2003
RESPS:57 HOURS:456 COSTS(000):$0
Paul Douglas Teacher Scholarship Program Performance Report
FORMS: 40-31P CFDA#84.176
OMB NO: 1840-0604 EXPIRATION DATE: 08/31/2003
RESPS:325 HOURS:13,432 COSTS(000):$0
Application Package for the Graduate Assistance in Areas of
National Need (GAANN) Fellowship Program
FORMS: CFDA=84.200
OMB NO: 1840-0616 EXPIRATION DATE: 06/30/2004
RESPS:50 HOURS:750 COSTS(000):$0
Application for Centers for International Business Education
Program
FORMS: CFDA-84.220
OMB NO: 1840-0619 EXPIRATION DATE: 07/31/2005
RESPS:300 HOURS:1,500 COSTS(000):$0
Application for Grants Under Ronald E. McMair Postbaccalaureate
Achievement Program
FORMS: NONE
OMB NO: 1840-0630 EXPIRATION DATE: 08/31/2004
RESPS:100 HOURS:400 COSTS(000):$8,000
Report of Financial Need and Certification for the Jacob K.
Javits Fellowship Program
FORMS: 40-1304 CFDA#84.170
OMB NO: 1840-0636 EXPIRATION DATE: 02/29/2004
RESPS:80 HOURS:2,400 COSTS(000):$0
European Community/United States of America Cooperation Program
in Higher Education and Vocational Education and Training
FORMS: ED40-514
OMB NO: 1840-0640 EXPIRATION DATE: 07/31/2003
RESPS:1 HOURS:702 COSTS(000):$17,160
Performance Report for the Ronald E. McNair Postbaccalaureate
Achievement Program
FORMS: CFDA-84.217
OMB NO: 1840-0702 EXPIRATION DATE: 08/31/2005
RESPS:20 HOURS:600 COSTS(000):$0
The Program for North American Mobility in Higher Education (JS)
FORMS: NONE
OMB NO: 1840-0729 EXPIRATION DATE: 08/31/2003
RESPS:30 HOURS:150 COSTS(000):$0
Final Performance Report for the Business in International
Education Program
FORMS: NONE
OMB NO: 1840-0737 EXPIRATION DATE: 12/31/2005
RESPS:1 HOURS:9,000 COSTS(000):$0
Child Care Access Means Parents in School (CCAMPIS) Program - A
Guide for the Preparation of Applications
FORMS: CFDA-84.335A
OMB NO: 1840-0738 EXPIRATION DATE: 05/31/2005
RESPS:75 HOURS:2,250 COSTS(000):$0
Application Demonstration Projects for Faculty Training in
Disability Issues (1890-0001)
FORMS: 84.333
OMB NO: 1840-0740 EXPIRATION DATE: 04/30/2003
RESPS:300 HOURS:18,000 COSTS(000):$0
Application Package for Gaining Early Awareness and Readiness for
FORMS: NONE
OMB NO: 1840-0744 EXPIRATION DATE: 04/30/2003
RESPS:1,250 HOURS:127,624 COSTS(000):$3,757
Reference and Reporting Guide for Preparing State and
Institutional Reports on Teacher Quality and Preparation
FORMS: NONE
OMB NO: 1840-0746 EXPIRATION DATE: 12/31/2003
RESPS:50 HOURS:500 COSTS(000):$0
Application for Grants Under the TRIO Dissemination Partnership
Program (84.344) (1890-0001) (JS)
FORMS: 84.344
OMB NO: 1840-0748 EXPIRATION DATE: 03/31/2006
RESPS:1 HOURS:2,250 COSTS(000):$0
Graduate Assistance in Areas of National Need Performance Report
FORMS: NONE
OMB NO: 1840-0750 EXPIRATION DATE: 08/31/2004
RESPS:30,544 HOURS:6,340 COSTS(000):$0
Distance Education Demonstration Program Annual Reporting Form
FORMS: NONE
OMB NO: 1840-0755 EXPIRATION DATE: 05/31/2003
RESPS:100 HOURS:6,000 COSTS(000):$0
Application for Grants Under the Community Scholarship
Mobilization Program
FORMS: CFDA#84.347
OMB NO: 1840-0756 EXPIRATION DATE: 05/31/2003
RESPS:20 HOURS:400 COSTS(000):$0
First and Second Year Annual Progress Reports for the European
Community/US Joint Consortia Program
FORMS: ED-514
OMB NO: 1840-0759 EXPIRATION DATE: 02/28/2005
RESPS:1,411 HOURS:18,242 COSTS(000):$0
The Evaluation of Exchange, Language, International and Area
Studies (EELIAS), NRC, FLAS and IIPP, UISFUL, Business and
International Education Program (BIE), Centers for..............
FORMS: NONE
OMB NO: 1840-0760 EXPIRATION DATE: 07/31/2003
RESPS:60 HOURS:1,200 COSTS(000):$0
Annual Reporting Forms for the Program for North American
Mobility in Higher Education
FORMS: NONE
OMB NO: 1840-0761 EXPIRATION DATE: 10/31/2003
RESPS:80 HOURS:2,400 COSTS(000):$0
The US-Brazil Higher Education Consortia Program Application for
the US-Brazil Higher Education Consortia Program
FORMS: CFDA-84.116
OMB NO: 1840-0762 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:13,500 COSTS(000):$104
Annual Performance Report for the Upward Bound, Upward Bound
Math/Science, and Veterans Upward Bound Programs
FORMS: NONE
OMB NO: 1840-0763 EXPIRATION DATE: 02/29/2004
RESPS:1 HOURS:609 COSTS(000):$0
18 and 36 months Performance Reports for the Child Care Access
Parents in Schools Program
FORMS: NONE
OMB NO: 1840-0764 EXPIRATION DATE: 08/31/2004
RESPS:1 HOURS:2,000 COSTS(000):$0
Final Performance Report for Grants Under Title III -
Institutional Aid Programs
FORMS: CFDA#S-84.031A 84.031B 84.031N 84.031S 84.031T 84.031W 84.120A
OMB NO: 1840-0766 EXPIRATION DATE: 04/30/2005
RESPS:631 HOURS:11,358 COSTS(000):$0
Annual Performance Report for Title III and Title V Grantees
FORMS: 84.031A 84.031T 84.031N 84.031S 84.031W 84.120A
OMB NO: 1845-0006 EXPIRATION DATE: 09/30/2005
RESPS:2,887,200 HOURS:2,165,400 COSTS(000):$0
Federal Stafford Loan (Subsidized and Unsubsidized) Program
Master Promissory Note (JS)
FORMS: CFDA=84.032
OMB NO: 1845-0007 EXPIRATION DATE: 10/31/2005
RESPS:706,000 HOURS:353,000 COSTS(000):$0
Federal Direct Stafford/Ford Loan and Federal Direct
Unsubsidized Stafford/Ford Loan Master Promissory Note
FORMS: NONE
OMB NO: 1845-0009 EXPIRATION DATE: 10/31/2004
RESPS:100,000 HOURS:50,000 COSTS(000):$0
Federal PLUS Loan Program Application Documents (JS)
FORMS: NONE
OMB NO: 1845-0010 EXPIRATION DATE: 02/28/2006
RESPS:1,800 HOURS:9,900 COSTS(000):$0
Regulations for Equity in Athletics Disclosure Act (EADA) (JS)
FORMS: NONE
OMB NO: 1845-0011 EXPIRATION DATE: 06/30/2005
RESPS:1 HOURS:143,030 COSTS(000):$0
William D. Ford Federal Direct Loan Program Deferment Request
Forms
FORMS: NONE
OMB NO: 1845-0012 EXPIRATION DATE: 10/31/2005
RESPS:2,970 HOURS:20,830 COSTS(000):$0
Application for Approval to Participate in Federal Student
Financial Aid Programs
FORMS: E40-34P CFDA:84.007 84.032 84.033 84.063 84.038 84.268
OMB NO: 1845-0013 EXPIRATION DATE: 08/31/2003
RESPS:17,200 HOURS:41,925 COSTS(000):$0
Lender's Request for Payment of Interest and Special Allowance
(JS)
FORMS: ED-799
OMB NO: 1845-0014 EXPIRATION DATE: 11/30/2004
RESPS:1,927,000 HOURS:635,910 COSTS(000):$0
William D. Ford Federal Direct Loan Program Repayment Plan
Selection Form (JS)
FORMS: NONE
OMB NO: 1845-0015 EXPIRATION DATE: 06/30/2005
RESPS:55,200 HOURS:27,600 COSTS(000):$0
Federal Family Education Loan, Direct Loan, and Perkins Loan
Discharge Applications (JS)
FORMS: NONE
OMB NO: 1845-0016 EXPIRATION DATE: 01/31/2006
RESPS:690,685 HOURS:227,927 COSTS(000):$0
Direct Loan Income Contingent Repayment Plan Alternative
Documentation of Income (LO)
FORMS: 84.268
OMB NO: 1845-0017 EXPIRATION DATE: 01/31/2006
RESPS:314,861 HOURS:62,972 COSTS(000):$0
Direct Loan Income Contingent Repayment Plan - Consent to
Disclosure of Tax Information (LO)
FORMS: 84.268
OMB NO: 1845-0018 EXPIRATION DATE: 01/31/2006
RESPS:4,092 HOURS:818 COSTS(000):$0
William D. Ford Federal Direct Loan Program Statutory
Forbearance Forms (LO)
FORMS: NONE
OMB NO: 1845-0019 EXPIRATION DATE: 10/31/2005
RESPS:95,262 HOURS:25,859 COSTS(000):$0
Federal Perkins Loan Program Regulations and General Provision
Regulations
FORMS: CFDA=84.038
OMB NO: 1845-0020 EXPIRATION DATE: 10/31/2005
RESPS:858,981 HOURS:10,128,562 COSTS(000):$1,253
Federal Family Education Loan Program Regulations
FORMS: CFDA-84.032
OMB NO: 1845-0021 EXPIRATION DATE: 10/31/2005
RESPS:846,034 HOURS:211,520 COSTS(000):$0
William D. Ford Federal Direct Loan Program
FORMS: CFDA=84.0268
OMB NO: 1845-0022 EXPIRATION DATE: 10/31/2005
RESPS:93,877 HOURS:1,209,890 COSTS(000):$5,040
Cohort Default Rates for Institutions Participating in the FFEL
or Direct Loan Programs
FORMS: NONE
OMB NO: 1845-0023 EXPIRATION DATE: 10/31/2005
RESPS:2,800,642 HOURS:61,879 COSTS(000):$0
Federal Perkins Loan Program Regulations
FORMS: CFDA=84.037
OMB NO: 1845-0028 EXPIRATION DATE: 07/31/2004
RESPS:56 HOURS:112 COSTS(000):$0
The joint application for the Leveraging Educational Assistance
Partnership and Special LEAP Programs
FORMS: ED-1288
OMB NO: 1845-0030 EXPIRATION DATE: 04/30/2004
RESPS:1 HOURS:26,280 COSTS(000):$0
Fiscal Operations Report and Application to Participate (FISAP)
Opportunity Grant and Federal Work-Study Programs
FORMS: ED-646-1
OMB NO: 1845-0031 EXPIRATION DATE: 04/30/2003
RESPS:660,000 HOURS:132,000 COSTS(000):$0
William D. Ford Federal Direct Loan Program General Forberance
Request Form
FORMS: NONE
OMB NO: 1845-0035 EXPIRATION DATE: 05/31/2003
RESPS:29,952 HOURS:179,712 COSTS(000):$72
National Student Loan Data System (NSLDS)
FORMS: NONE
OMB NO: 1845-0036 EXPIRATION DATE: 06/30/2003
RESPS:263,000 HOURS:263,000 COSTS(000):$0
Federal Family Education Loan Program Federal Consolidation Loan
Application and Promissory Note
FORMS: NONE
OMB NO: 1845-0039 EXPIRATION DATE: 06/30/2003
RESPS:3,950,083 HOURS:396,200 COSTS(000):$2,959
Federal Pell Grant Program Recipient Financial Management System
(RFMS)
FORMS: CFDA#84.063
OMB NO: 1845-0040 EXPIRATION DATE: 02/28/2005
RESPS:210,000 HOURS:6,993 COSTS(000):$0
William D. Ford Federal Direct Loan (Direct Loan) Program
Electronic Debit Account Application and Brochure (JS)
FORMS: NONE
OMB NO: 1845-0041 EXPIRATION DATE: 06/30/2004
RESPS:1 HOURS:354,453 COSTS(000):$65,000
Student Assistance General Provisions - Subpart E (Verification
of Student Aid Application Information)
FORMS: NONE
OMB NO: 1845-0042 EXPIRATION DATE: 02/28/2005
RESPS:1,804 HOURS:487 COSTS(000):$0
Lender's Application for Payment of Insurance Claim
FORMS: ED-1207
OMB NO: 1845-0044 EXPIRATION DATE: 03/31/2005
RESPS:56 HOURS:560 COSTS(000):$0
The Leveraging Educational Assistance Partnership (LEAP) and
Special Leveraging Educational Assistance Partnership (SLEAP)
Programs
FORMS: ED-FORM-1288-1 CFDA-84.069A-B
OMB NO: 1845-0045 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:6,000 COSTS(000):$0
Clearance Package for OSFA customer Satisfaction Survey Master
Plan
FORMS: NONE
OMB NO: 1845-0047 EXPIRATION DATE: 08/31/2004
RESPS:300,000 HOURS:75,000 COSTS(000):$0
Income Contingent Repayment Plan Consent to Disclosure of Tax
Information
FORMS: NONE
OMB NO: 1845-0048 EXPIRATION DATE: 04/30/2003
RESPS:21,262 HOURS:10,631 COSTS(000):$0
Federal Perkins/NDSL Loan Assignment form (JS)
FORMS: ED-553 CFDA#84.038
OMB NO: 1845-0051 EXPIRATION DATE: 04/30/2003
RESPS:81,458 HOURS:40,729 COSTS(000):$55
Federal Direct PLUS Loan Application and Promissory Note
FORMS: NONE
OMB NO: 1845-0052 EXPIRATION DATE: 04/30/2005
RESPS:93,837 HOURS:23,209 COSTS(000):$71
Student Assistance General Provisions--Subpart I--Immigration
Status Confirmation
FORMS: NONE
OMB NO: 1845-0053 EXPIRATION DATE: 01/31/2005
RESPS:1,028,500 HOURS:681,875 COSTS(000):$0
Federal Direct Coonsolidation Loan Program Application Documents
(JS)
FORMS: NONE
OMB NO: 1845-0054 EXPIRATION DATE: 10/31/2004
RESPS:500 HOURS:2,500 COSTS(000):$0
Notice Inviting Proposals for Participation in the Experimental
Sites Initiative (JS)
FORMS: 84.07 84.032 84.033 84.063 84.038 84.268
OMB NO: 1845-0055 EXPIRATION DATE: 10/31/2004
RESPS:125 HOURS:125 COSTS(000):$0
Federal Register Notice Inviting Applications for Participation
in the Quality Assurance Program
FORMS: NONE
OMB NO: 1845-0057 EXPIRATION DATE: 06/30/2005
RESPS:2,790 HOURS:618 COSTS(000):$0
Child Care Provider Loan Forgiveness Application and Forgiveness
Forbearance form (JS)
FORMS: NONE
OMB NO: 1845-0059 EXPIRATION DATE: 10/31/2004
RESPS:21,425 HOURS:6,929 COSTS(000):$0
Federal Direct Loan Program and Federal Family Education Loan
Program Teacher Loan Forgiveness Form
FORMS: NONE
OMB NO: 1845-0060 EXPIRATION DATE: 04/30/2003
RESPS:20,365 HOURS:10,183 COSTS(000):$0
Endorser Addendum to Federal Direct PLUS Loan Application and
Promissory Note (JS)
FORMS: NONE
OMB NO: 1845-0068 EXPIRATION DATE: 01/31/2006
RESPS:225,000 HOURS:112,500 COSTS(000):$0
Federal Direct PLUS Loan Application and Master Promissory Note
(PLUS MPN), and Endorser Addendum
FORMS: NONE
OMB NO: 1845-0069 EXPIRATION DATE: 01/31/2006
RESPS:33,333 HOURS:16,667 COSTS(000):$0
Federal PLUS Program Maser Promissory Note (JS)
FORMS: CFDA-84.032
OMB NO: 1845-0072 EXPIRATION DATE: 09/30/2003
RESPS:4,000 HOURS:4,000 COSTS(000):$200
eZ-Audit: Electronic Submission of Financial Statements and
Compliance Audits
FORMS: NONE
OMB NO: 1850-0067 EXPIRATION DATE: 11/30/2004
RESPS:284 HOURS:11,004 COSTS(000):$0
Common Core of Data Surveys
FORMS: NONE
OMB NO: 1850-0582 EXPIRATION DATE: 04/30/2003
RESPS:60,282 HOURS:202,636 COSTS(000):$0
Integrated Postsecondary Education Data System (IPEDS),
Introduction of the Web-Based Collection on Institutional Price
& Student Financial Aid and modifications to the 2000-2002
data....
FORMS: NONE
OMB NO: 1850-0598 EXPIRATION DATE: 08/31/2004
RESPS:2,764 HOURS:2,232 COSTS(000):$0
Field test activities and the 2003-2004 full-scale Schools and
Staffing Survey (SASS): LEA, Principal, School, Teacher, Library
FORMS: NONE
OMB NO: 1850-0601 EXPIRATION DATE: 05/31/2003
RESPS:750 HOURS:11,250 COSTS(000):$0
Application for the Field-Initiated Studies Educational Research
Grant Program
FORMS: NONE
OMB NO: 1850-0729 EXPIRATION DATE: 03/31/2005
RESPS:10,063 HOURS:4,081 COSTS(000):$0
Baccalaureate and Beyond Longitudinal Study, Third Followup
(B&B:93/2003)
FORMS: NONE
OMB NO: 1850-0733 EXPIRATION DATE: 10/31/2003
RESPS:10,518 HOURS:7,889 COSTS(000):$0
NCES Quick Response Information System (KA)
FORMS: NONE
OMB NO: 1850-0746 EXPIRATION DATE: 05/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Standards for Evaluation of the Performance of Recipients of
OERI Grants, Cooperative Agreements, and Contracts
FORMS: NONE
OMB NO: 1850-0750 EXPIRATION DATE: 02/28/2005
RESPS:22,253 HOURS:14,990 COSTS(000):$0
Early Childhood Longitudinal Study (ECLS) - Kindergarten cohort,
third grade followup, field test for fourth and fifth grade
survey activities
FORMS: NONE
OMB NO: 1850-0755 EXPIRATION DATE: 06/30/2004
RESPS:10,800 HOURS:29,875 COSTS(000):$0
Program for International Student Assessment (PISA)
FORMS: NONE
OMB NO: 1850-0758 EXPIRATION DATE: 10/31/2004
RESPS:97,750 HOURS:24,500 COSTS(000):$0
National Assessment of Educational Progress, 2002 Field Test and
2003 Full Scale Assessment of Reading, Math, and Foreign Language
FORMS: NONE
OMB NO: 1850-0763 EXPIRATION DATE: 04/30/2003
RESPS:80 HOURS:9,600 COSTS(000):$0
Application for a Comprehensive School Reform Educational
Research Grant
FORMS: NONE
OMB NO: 1850-0768 EXPIRATION DATE: 02/28/2005
RESPS:62,627 HOURS:10,750 COSTS(000):$0
National Househld Education Surveys Program of 2003 (NHES: 2003)
FORMS: NONE
OMB NO: 1850-0769 EXPIRATION DATE: 09/30/2003
RESPS:36,253 HOURS:15,721 COSTS(000):$0
The Impact of ICT on Learning: Quasi-Experimental Study
FORMS: NONE
OMB NO: 1850-0771 EXPIRATION DATE: 12/31/2003
RESPS:5,750 HOURS:1,438 COSTS(000):$0
NAEP Technology Based Assessment Project, Pretest and Field Test
FORMS: NONE
OMB NO: 1850-0776 EXPIRATION DATE: 12/31/2003
RESPS:1,500 HOURS:4,500 COSTS(000):$0
International Adult Literacy and Lifeskills Survey (KI)
FORMS: NONE
OMB NO: 1850-0783 EXPIRATION DATE: 11/30/2005
RESPS:8,791 HOURS:5,242 COSTS(000):$0
Preschool Curricula Evaluation Research (PCER) Program
FORMS: NONE
OMB NO: 1850-0784 EXPIRATION DATE: 03/31/2006
RESPS:3,500 HOURS:1,155 COSTS(000):$46,200
Even Start and Title I Preschool Classroom Literacy Environment
and Outcomes Study (JM)
FORMS: NONE
OMB NO: 1855-0001 EXPIRATION DATE: 05/31/2005
RESPS:30 HOURS:720 COSTS(000):$0
Application for Grants, Public Charter Schools Program
(1890-0001) (KA)
FORMS: NONE
OMB NO: 1855-0003 EXPIRATION DATE: 08/31/2003
RESPS:58 HOURS:226 COSTS(000):$0
Goals 2000, Parental Information and Resource Center's Annual/
Final Performance Report (JM)
FORMS: NONE
OMB NO: 1855-0004 EXPIRATION DATE: 05/31/2003
RESPS:200 HOURS:3,200 COSTS(000):$0
Arts in Education Competitive Grants Program
FORMS: CFDA-84.926B
OMB NO: 1855-0005 EXPIRATION DATE: 05/31/2004
RESPS:200 HOURS:6,000 COSTS(000):$0
Applications for Grants Under the Dropout Prevention
Demonstration Program
FORMS: NONE
OMB NO: 1855-0006 EXPIRATION DATE: 05/31/2004
RESPS:60 HOURS:3,600 COSTS(000):$0
Applications for Grants Under the Arts in Education
Demonstration and Dissemination Grant Program
FORMS: NONE
OMB NO: 1855-0007 EXPIRATION DATE: 02/28/2006
RESPS:30 HOURS:2,400 COSTS(000):$0
Credit Enhancement for Charter School Facilities Program
FORMS: NONE
OMB NO: 1855-0008 EXPIRATION DATE: 05/31/2003
RESPS:211 HOURS:2,975 COSTS(000):$0
Technology Innovation Challenge Grant Program Online Annual
FORMS: CFDA-84.303A
OMB NO: 1855-0009 EXPIRATION DATE: 05/31/2003
RESPS:23 HOURS:3,260 COSTS(000):$0
Star Schools Program Online Annual Performance Reporting System
FORMS: NONE
Office of Intergovernmental and Interagency Affairs
OMB NO: 1860-0504 EXPIRATION DATE: 11/30/2004
RESPS:2,600 HOURS:41,600 COSTS(000):$0
Applications for the U.S. Presidential Scholars Program
FORMS: NONE
OMB NO: 1860-0505 EXPIRATION DATE: 10/31/2004
RESPS:720 HOURS:60 COSTS(000):$0
Sign-on form for Partnership for Family Involvement in Education
FORMS: NONE
OMB NO: 1860-0506 EXPIRATION DATE: 11/30/2005
RESPS:420 HOURS:16,800 COSTS(000):$0
No Child Left Behind--Blue Ribbon Schools Program
FORMS: NONE
OMB NO: 1865-0001 EXPIRATION DATE: 11/30/2003
RESPS:400 HOURS:9,500 COSTS(000):$0
Safe and Drug-Free Schools and Communities National
Programs--Federal Activities Discretionary Grant Program
FORMS: CFDA#84.184K 84.184M
OMB NO: 1865-0003 EXPIRATION DATE: 07/31/2003
RESPS:75 HOURS:1,650 COSTS(000):$0
Safe and Drug-Free Schools and Communities National Programs--
Federal Activities--Grant Competition to Prevent High-Risk
Drinking and Violent Behavior Among College Students
FORMS: 84.184H
OMB NO: 1865-0006 EXPIRATION DATE: 01/31/2006
RESPS:50,000 HOURS:30,000 COSTS(000):$0
National College Alcohol, Drug and Violence Survey
FORMS: NONE
OMB NO: 1865-0008 EXPIRATION DATE: 04/30/2003
RESPS:400 HOURS:11,200 COSTS(000):$0
Elementary School Counseling Demonstration Program
FORMS: NONE
OMB NO: 1865-0009 EXPIRATION DATE: 09/30/2003
RESPS:56 HOURS:2,240 COSTS(000):$0
Safe and Drug-Free Schools and Communities Act of the Governor's
Report Forms
FORMS: NONE
OMB NO: 1870-0500 EXPIRATION DATE: 12/31/2003
RESPS:33,000 HOURS:337,500 COSTS(000):$0
2002 Elementary and Secondary School Survey (also referred to as
the Elementary and Secondary School Civil Rights Compliance
Report)
FORMS: NONE
OMB NO: 1875-0183 EXPIRATION DATE: 11/30/2003
RESPS:26,325 HOURS:42,090 COSTS(000):$0
Evaluation of the 21st Century Community Learning Centers Program
FORMS: NONE
OMB NO: 1875-0185 EXPIRATION DATE: 09/30/2003
RESPS:303 HOURS:1,515 COSTS(000):$0
Annual Performance Report for the Preparing Tomorrow's Teachers
FORMS: NONE
OMB NO: 1875-0186 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:7,916 COSTS(000):$0
Moving Standards to the Classroom: A Study of Standard-Based
Mathematics Instruction in Six States
FORMS: NONE
OMB NO: 1875-0191 EXPIRATION DATE: 10/31/2003
RESPS:11,565 HOURS:5,210 COSTS(000):$0
The National Evaluation of GEAR UP
FORMS: NONE
OMB NO: 1875-0193 EXPIRATION DATE: 02/29/2004
RESPS:3,000 HOURS:1,500 COSTS(000):$0
Study to Assess the Quality of Vocational Education in the
United States
FORMS: NONE
OMB NO: 1875-0194 EXPIRATION DATE: 11/30/2003
RESPS:873 HOURS:2,055 COSTS(000):$99
Assessing Literacy Models in the Boston Public Schools (JM)
FORMS: NONE
OMB NO: 1875-0195 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:15,408 COSTS(000):$0
Redesignation of Students Served by Title VII Projects
(1890-0001) (JM)
FORMS: NONE
OMB NO: 1875-0196 EXPIRATION DATE: 03/31/2004
RESPS:1,298 HOURS:1,044 COSTS(000):$0
Evaluation of the Federal Class Size Reduction Program (JM)
FORMS: NONE
OMB NO: 1875-0199 EXPIRATION DATE: 05/31/2005
RESPS:1,275 HOURS:2,513 COSTS(000):$0
Evaluation of the Partnership Grants Program, Title II, Higher
Education Act Revision of Collection
FORMS: NONE
OMB NO: 1875-0201 EXPIRATION DATE: 05/31/2004
RESPS:2,200 HOURS:1,000 COSTS(000):$0
Evaluation of the State Grants Program and Teacher Recruitment
FORMS: NONE
OMB NO: 1875-0203 EXPIRATION DATE: 05/31/2004
RESPS:249 HOURS:9,520 COSTS(000):$0
GEPA Section 424 Data Collection on the Distribution of Federal
Education Funds (JM)
FORMS: NONE
OMB NO: 1875-0204 EXPIRATION DATE: 06/30/2004
RESPS:14,326 HOURS:13,753 COSTS(000):$0
Study of the SDFSCA Middle School Coordinator Initiative
FORMS: NONE
OMB NO: 1875-0205 EXPIRATION DATE: 01/31/2005
RESPS:6,384 HOURS:5,829 COSTS(000):$0
Evaluation of Title I Accountability Systems and School
Improvement Efforts (TASSIE)
FORMS: NONE
OMB NO: 1875-0207 EXPIRATION DATE: 08/31/2004
RESPS:2,000 HOURS:8,000 COSTS(000):$0
National Study of Title I Schools - Sampling Package
FORMS: NONE
OMB NO: 1875-0210 EXPIRATION DATE: 08/31/2004
RESPS:168 HOURS:144 COSTS(000):$0
State Vocational Directors Survey on Perkins III Funding and
Accountability Systems
FORMS: NONE
OMB NO: 1875-0212 EXPIRATION DATE: 10/31/2004
RESPS:106 HOURS:264 COSTS(000):$0
Study of State Administration of Even Start and Statewide Family
Literacy Initiative Grants
FORMS: NONE
OMB NO: 1875-0215 EXPIRATION DATE: 02/28/2005
RESPS:1,035 HOURS:735 COSTS(000):$0
The Reading Excellence Act School and Classroom Implementation
and Impact Study, Sampling Clearance Package
FORMS: NONE
OMB NO: 1875-0217 EXPIRATION DATE: 03/31/2005
RESPS:1,377 HOURS:3,123 COSTS(000):$282,745
The National Evaluation of Smaller Learning Communities (SC)
FORMS: NONE
OMB NO: 1875-0218 EXPIRATION DATE: 02/28/2005
RESPS:1,005 HOURS:488 COSTS(000):$0
Information Technology Skill Certification Study
FORMS: NONE
OMB NO: 1875-0219 EXPIRATION DATE: 04/30/2005
RESPS:2,897 HOURS:909 COSTS(000):$0
An Evaluation of the Rehabilitation Services Administration
(RSA) Training Programs' Responsiveness to State VR Agency Needs
for Qualified Personnel
FORMS: NONE
OMB NO: 1875-0221 EXPIRATION DATE: 07/31/2003
RESPS:220 HOURS:272 COSTS(000):$0
Study to Assess Funding, Accountability, and One-Stop Delivery
Systems in Adult Education
FORMS: NONE
OMB NO: 1875-0222 EXPIRATION DATE: 01/31/2006
RESPS:4,380 HOURS:2,567 COSTS(000):$0
Longitudinal Assessment of CSR Implementation and Outcomes
(LACIO)
FORMS: NONE
OMB NO: 1885-0513 EXPIRATION DATE: 08/31/2004
RESPS:1,313 HOURS:7,828 COSTS(000):$0
Biennial Report Form for the Emergency Immigrant Education
FORMS: ED-T85-IP
OMB NO: 1885-0531 EXPIRATION DATE: 11/30/2003
RESPS:300 HOURS:7,650 COSTS(000):$0
Application for Grants Under School Improvement: Elementary
School Foreign Language Incentive Program (SC)
FORMS: 84.294A
OMB NO: 1885-0540 EXPIRATION DATE: 01/31/2006
RESPS:250 HOURS:20,000 COSTS(000):$0
School Improvement: Foreign Language Assistance Program for
Local Educational Agencies (1890-0001)(SC)
FORMS: 84.293B
OMB NO: 1885-0544 EXPIRATION DATE: 01/31/2006
RESPS:50 HOURS:4,000 COSTS(000):$0
School Improvement Foreign Language Assistance Program for State
Educational Agencies (1890-0001)(SC)
FORMS: 84.293C
OMB NO: 1885-0550 EXPIRATION DATE: 04/30/2004
RESPS:300 HOURS:30,600 COSTS(000):$0
Application for Grants Under English Language Acquisition:
National Professional Development Program (1890-0001) (SC)
FORMS: NONE
OMB NO: 1885-0551 EXPIRATION DATE: 10/31/2005
RESPS:100 HOURS:8,200 COSTS(000):$0
Application for Grants Under English Language Acquisition and
Language Enhancement: Native American and Alaska Native Children
in School (SC)
FORMS: NONE
OMB NO: 1890-0006 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:1 COSTS(000):$0
Sreamlined Process for Education Department General
Administrative Regulations (EDGAR) Approved Grant Applications
FORMS: NONE
OMB NO: 1890-0007 EXPIRATION DATE: 09/30/2004
RESPS:21,200 HOURS:31,800 COSTS(000):$0
GEPA Section 427 Guidance for All Grant Applications (JM)
FORMS: NONE
OMB NO: 1890-0009 EXPIRATION DATE: 06/30/2005
RESPS:10,297 HOURS:244,906 COSTS(000):$0
Generic Application Package for Discretionary Grant Programs
FORMS: NONE
OMB NO: 1890-0012 EXPIRATION DATE: 02/28/2006
RESPS:250 HOURS:10,000 COSTS(000):$0
Small Business Innovation Research (SBIR) Program - Phase I -
Grant Application Package
FORMS: CFDA#-84.133S 84.305S 84.191S 84.051S 84.017S
OMB NO: 1890-0014 EXPIRATION DATE: 01/31/2006
RESPS:17,000 HOURS:1,360 COSTS(000):$0
Survey on Ensuring Equal Opportunity for Applicants
FORMS: NONE
OMB NO: 1890-0015 EXPIRATION DATE: 03/31/2006
RESPS:50 HOURS:3,750 COSTS(000):$0
Small Business Innovation Research (SBIR) Program - Phase II -
Grant Application Package
FORMS: 84.133S 84.305S 84.191S 84.051S 84.017S
OMB NO: 1910-4100 EXPIRATION DATE: 02/28/2005
RESPS:3,811 HOURS:1,086,529 COSTS(000):$0
Procurement (see attached chart for the collection requirements).
FORMS: NONE
OMB NO: 1910-5101 EXPIRATION DATE: 03/31/2006
RESPS:310 HOURS:1,550 COSTS(000):$0
U.S Dept. of Energy: Annual Alternative Fuel Vehical Acquisition
Report for State Government & Alternative Fuel Provider Fleets
FORMS: DOE\FCVT\101
OMB NO: 1910-5102 EXPIRATION DATE: 03/31/2006
RESPS:36 HOURS:5,350 COSTS(000):$0
Make or Buy Plans
FORMS: NONE
OMB NO: 1910-5104 EXPIRATION DATE: 08/31/2004
RESPS:41 HOURS:12,300 COSTS(000):$452
10 CFR 431 -- Energy Efficiency Program for Certain Commercial
and Industrial Equipment: Test Procedures, Labeling, and
Certification Requirements for Electric Motors
FORMS: NONE
OMB NO: 1910-5111 EXPIRATION DATE: 04/30/2003
RESPS:20 HOURS:100 COSTS(000):$0
Disclosure of Relevant Interests by Firms That Are Members of
Apparent Successful Offeror Joint Venture of Other Formal
Teaming Arrangement
FORMS: NONE
OMB NO: 0910-0001 EXPIRATION DATE: 03/31/2005
RESPS:20,360 HOURS:1,984,003 COSTS(000):$0
Applications for FDA Approval to Market a New Drug -- Part 314
FORMS: NONE
OMB NO: 0910-0012 EXPIRATION DATE: 04/30/2003
RESPS:6,750 HOURS:54,225 COSTS(000):$0
Veterinary Adverse Drug Reaction, Lack of Effectiveness, Product
Defect Report, and Transmittal of Periodic Reports and
Promotional Material for New Animal Drugs. 21 CFR Part 510
FORMS: FDA-1932 FDA-1932A FDA-2301
OMB NO: 0910-0014 EXPIRATION DATE: 01/31/2006
RESPS:541,986 HOURS:36,040,829 COSTS(000):$0
Investigational New Drug (IND) Regulations
FORMS: FDA-1571 FDA-1572
OMB NO: 0910-0025 EXPIRATION DATE: 11/30/2003
RESPS:47,343 HOURS:324,957 COSTS(000):$0
Reporting and Recordkeeping Requirements and Availability of
Sample Electronic Products for Manufacturers and Distributors of
Electronic
FORMS: FDA-2579 FDA-2767 FDA-2877 FDA-3147
OMB NO: 0910-0032 EXPIRATION DATE: 07/31/2004
RESPS:1,582 HOURS:383,793 COSTS(000):$0
New Animal Drug Application, 21 CFR Part 514
FORMS: FDA-356V
OMB NO: 0910-0037 EXPIRATION DATE: 08/31/2005
RESPS:8,050 HOURS:1,502,828 COSTS(000):$0
Food Canning Establishment Registration Process Filing and
Recordkeeping for Acidified Foods and Thermally Processed
Low-Acid Foods in hermetically Sealed Containers
FORMS: 2541 2541A 2541C
OMB NO: 0910-0045 EXPIRATION DATE: 07/31/2004
RESPS:66,223 HOURS:33,112 COSTS(000):$0
Registration of Producers of Drugs and Lisitng of Drugs in
Commercial Distribution
FORMS: 2656 2656E 2657 2658
OMB NO: 0910-0052 EXPIRATION DATE: 02/28/2006
RESPS:3,167 HOURS:1,753 COSTS(000):$0
Blood Establishment Registration and Product Listing Form FDA
2830
FORMS: FDA-2830
OMB NO: 0910-0053 EXPIRATION DATE: 10/31/2004
RESPS:411 HOURS:2,910 COSTS(000):$0
Radioactive Drug Research Committee (RDRC) Report on Research
Use of Radioactive Drug Study Summary
FORMS: FDA-2914 FDA-2915
OMB NO: 0910-0073 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:3,167,670 COSTS(000):$1,182
Medical Devices: Current Good Manufacturing Practice (CGMP),
Quality System (Q/S) Regulation; 21 CFR Part 820
FORMS: NONE
OMB NO: 0910-0114 EXPIRATION DATE: 08/31/2003
RESPS:26 HOURS:461 COSTS(000):$0
Administrative Detention and Banned Medical Devices
FORMS: NONE
OMB NO: 0910-0116 EXPIRATION DATE: 11/30/2005
RESPS:42,435 HOURS:335,346 COSTS(000):$0
Current Good Manufacturing Practices and Related Regulations for
Blood and Blood Components; and "Lookback" Requirements
FORMS: NONE
OMB NO: 0910-0117 EXPIRATION DATE: 03/31/2005
RESPS:21,510 HOURS:68,245 COSTS(000):$0
New Animal Drugs for Investigational Use - 21 CFR Part 511
FORMS: 3458
OMB NO: 0910-0119 EXPIRATION DATE: 09/30/2004
RESPS:36,150 HOURS:1,311,157 COSTS(000):$0
Good Laboratory Practice (GLP) Regulations for Nonclinical
Laboratory Studies - 21 CFR Part 58
FORMS: NONE
OMB NO: 0910-0129 EXPIRATION DATE: 05/31/2003
RESPS:3 HOURS:330 COSTS(000):$0
Applications for Exemption From Federal Preemption of State and
Local Medical Device Requirements-21 CFR Part 808
FORMS: NONE
OMB NO: 0910-0130 EXPIRATION DATE: 09/30/2004
RESPS:29,200 HOURS:131,400 COSTS(000):$0
Protection of Human Subjects; Recordkeeping and Reporting
Requirements for Institutional Review Boards (IRB's)
FORMS: NONE
OMB NO: 0910-0131 EXPIRATION DATE: 11/30/2003
RESPS:1,800 HOURS:7,200 COSTS(000):$0
Agreement for Shipments of Devices for Sterilization
FORMS: NONE
OMB NO: 0910-0132 EXPIRATION DATE: 11/30/2003
RESPS:1 HOURS:2,614 COSTS(000):$0
Affirmation of Generally Recognized as Safe GRAS Status
FORMS: NONE
OMB NO: 0910-0138 EXPIRATION DATE: 01/31/2006
RESPS:6 HOURS:3,000 COSTS(000):$0
Reclassification Petitions for Medical Devices
FORMS: FDA-3427 3428 3429
OMB NO: 0910-0139 EXPIRATION DATE: 08/31/2005
RESPS:4,184 HOURS:848,625 COSTS(000):$0
Current Good Manufacturing Practice; Proposed Amendment of
Certain Requirements for Finished Pharmaceuticals
FORMS: NONE
OMB NO: 0910-0152 EXPIRATION DATE: 09/30/2004
RESPS:36,444,150 HOURS:7,317,151 COSTS(000):$0
Current Good Manufacturing Practice for Medicated Feed, 21 CFR
Part 225
FORMS: NONE
OMB NO: 0910-0154 EXPIRATION DATE: 09/30/2004
RESPS:180,550 HOURS:187,450 COSTS(000):$0
Good Manufacturing Practice for Type A Medicated Articles, 21
CFR Part 226
FORMS: NONE
OMB NO: 0910-0182 EXPIRATION DATE: 04/30/2004
RESPS:23,070,000 HOURS:19,225 COSTS(000):$0
Use of Impact Resistant Lenses in Eyeglasses and Sunglasses OMB
No. 0910-0182
FORMS: NONE
OMB NO: 0910-0183 EXPIRATION DATE: 03/31/2006
RESPS:476 HOURS:5,678 COSTS(000):$0
General Administrative Procedures: Citizen Petitions; Petition
for Reconsideration or Stay of Action; Advisory Opinions
FORMS: NONE
OMB NO: 0910-0184 EXPIRATION DATE: 02/28/2006
RESPS:10 HOURS:200 COSTS(000):$0
Filing Objections and Requests for a Hearing on a Regulation or
Order
FORMS: NONE
OMB NO: 0910-0185 EXPIRATION DATE: 07/31/2005
RESPS:3 HOURS:6,000 COSTS(000):$9
Labeling Requirements for Color Additives (other than hair dyes)
and Petitions
FORMS: NONE
OMB NO: 0910-0186 EXPIRATION DATE: 04/30/2003
RESPS:360 HOURS:360 COSTS(000):$0
Irradiation in the Production, Processing and Handling of Food
FORMS: NONE
OMB NO: 0910-0188 EXPIRATION DATE: 07/31/2005
RESPS:3 HOURS:18,956 COSTS(000):$0
Infant Formula Recall Regulations - 21 CFR Part 107
FORMS: NONE
OMB NO: 0910-0231 EXPIRATION DATE: 08/31/2004
RESPS:487 HOURS:107,321 COSTS(000):$0
Premarket Approval of Medical Devices; 21 CFR Part 814
FORMS: NONE
OMB NO: 0910-0233 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:100 COSTS(000):$0
Patent Term Restoration, due Diligence Petitions, Filing,
Format, and Content of Petitions
FORMS: NONE
OMB NO: 0910-0277 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:40 COSTS(000):$0
State Petitions for Exemption from Preemption
FORMS: NONE
OMB NO: 0910-0279 EXPIRATION DATE: 06/30/2004
RESPS:1 HOURS:609 COSTS(000):$0
Year 2001 Updates of a National Survey of Prescription Drug
Informaion Provided to Patients
FORMS: NONE
OMB NO: 0910-0291 EXPIRATION DATE: 04/30/2003
RESPS:332,414 HOURS:332,414 COSTS(000):$0
MedWatch: The FDA Medical Products Reporting Program
FORMS: FDA-3500 3500A
OMB NO: 0910-0308 EXPIRATION DATE: 04/30/2003
RESPS:17,406 HOURS:268,803 COSTS(000):$0
Adverse Experience Reporting for Licensed Biological Products;
and General Records
FORMS: N/A
OMB NO: 0910-0309 EXPIRATION DATE: 02/29/2004
RESPS:39,996,722 HOURS:3,516,183 COSTS(000):$21
Mammography Facilities, Standards, and Lay Summaries For Patients
FORMS: FDA-3422
OMB NO: 0910-0320 EXPIRATION DATE: 08/31/2004
RESPS:206 HOURS:555 COSTS(000):$0
Request for Information from U.S. Processors that Export to the
European Community
FORMS: NONE
OMB NO: 0910-0341 EXPIRATION DATE: 05/31/2003
RESPS:924 HOURS:157 COSTS(000):$0
FDA Safety Alert/Public Health Advisory Readership Survey
FORMS: NONE
OMB NO: 0910-0342 EXPIRATION DATE: 05/31/2003
RESPS:60 HOURS:9,900 COSTS(000):$0
Notice of a Claim for GRAS exemption based on a GRAS
Determination
FORMS: NONE
OMB NO: 0910-0353 EXPIRATION DATE: 03/31/2004
RESPS:18 HOURS:1,178 COSTS(000):$0
Sterility Requirement for Aqueous-Based Drug Products for Oral
Inhalation; final rule
FORMS: NONE
OMB NO: 0910-0354 EXPIRATION DATE: 02/29/2004
RESPS:5,850 HOURS:627,075 COSTS(000):$0
Procedures for the Safe Processing and Importing of Fish and
Fishery Products; 21 CFR Part 123
FORMS: NONE
OMB NO: 0910-0356 EXPIRATION DATE: 02/29/2004
RESPS:860 HOURS:544,036 COSTS(000):$0
Substantial Evidence of Effectiveness of New Animal Drugs
FORMS: NONE
OMB NO: 0910-0359 EXPIRATION DATE: 03/31/2005
RESPS:880 HOURS:13,200 COSTS(000):$0
Reports of corrections and Removals; 21 CFR Part 806
FORMS: NONE
OMB NO: 0910-0364 EXPIRATION DATE: 04/30/2004
RESPS:30 HOURS:30 COSTS(000):$15
Nutrition Labeline: Declaration of Caloric Amounts and Serving
Sizes for Breath Mints
FORMS: NONE
OMB NO: 0910-0368 EXPIRATION DATE: 03/31/2004
RESPS:20 HOURS:2,000 COSTS(000):$0
OTC Test Sample Collection Systems for Drugs of Abuse Testing -
21 CFR Part 809
FORMS: NONE
OMB NO: 0910-0370 EXPIRATION DATE: 07/31/2004
RESPS:588 HOURS:1,920 COSTS(000):$0
Specific Requirements on Content and Format of Labeling;
Geriatric Use Subsection
FORMS: NONE
OMB NO: 0910-0374 EXPIRATION DATE: 08/31/2005
RESPS:3 HOURS:1,153 COSTS(000):$0
Guidance for Industry: Notification of a Health Claim or
Nutrient Content Claim Based on an Authoritative Statement of a
Scientific Body
FORMS: NONE
OMB NO: 0910-0375 EXPIRATION DATE: 10/31/2004
RESPS:140 HOURS:7,960 COSTS(000):$0
Medical Devices; Third Party Review Under FDAMA
FORMS: NONE
OMB NO: 0910-0376 EXPIRATION DATE: 10/31/2004
RESPS:16,640 HOURS:33,280 COSTS(000):$0
Transmittal of Advertising and Promotional Labeling for Drugs
and Biologics for Human Use
FORMS: FDA-2253
OMB NO: 0910-0378 EXPIRATION DATE: 03/31/2005
RESPS:220 HOURS:5,760 COSTS(000):$0
Medical Devices; Third-Party Premarket Submission Review and
Quality System Inspections Under U.S./E.C. Mutual Recognition
Agreement
FORMS: NONE
OMB NO: 0910-0387 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:66,461 COSTS(000):$0
Medical Device Registration and Listing: 21 CFR Parts 807.22 and
807.31
FORMS: 2891 2891A 2782
OMB NO: 0910-0389 EXPIRATION DATE: 06/30/2005
RESPS:86 HOURS:6,480 COSTS(000):$0
Guidance for Industry: Fast Track Drug Development Programs -
Designation, Development & Application Review
FORMS: NONE
OMB NO: 0910-0390 EXPIRATION DATE: 11/30/2005
RESPS:4,492 HOURS:52,208 COSTS(000):$0
Dissemination of Information on Unapproved/New Uses for Marketed
Drugs, Biologics, and Devices
FORMS: NONE
OMB NO: 0910-0392 EXPIRATION DATE: 10/31/2005
RESPS:64 HOURS:18,557 COSTS(000):$80,000
Regulations Requiring Manufacturers to Assess the Safety and
Effectiveness of New Drugs and Biological Products in Pediatric
Patients
FORMS: NONE
OMB NO: 0910-0409 EXPIRATION DATE: 09/30/2005
RESPS:2 HOURS:4,000 COSTS(000):$0
Regulations for In Vivo Radiopharmaceuticals Used for Diagnosis
and Monitoring
FORMS: NONE
OMB NO: 0910-0423 EXPIRATION DATE: 04/30/2003
RESPS:2 HOURS:247 COSTS(000):$0
New Drug and Biological Drug Products; Evidence Needed to
Demonstrate Efficacy of New Drugs for Use Against Lethal or
Permanently Disabling Toxic Substances When Efficacy Studies...
FORMS: NONE
OMB NO: 0910-0428 EXPIRATION DATE: 12/31/2005
RESPS:25 HOURS:25 COSTS(000):$0
Record Retention Requirements for the Soy Protein/CHD Health
Claim
FORMS: NONE
OMB NO: 0910-0429 EXPIRATION DATE: 02/28/2006
RESPS:3,103 HOURS:42,760 COSTS(000):$0
Guidance for Industry on Formal Mettings with Sponsors and
Applicants for PDUFA Products
FORMS: 1571 1572 356H
OMB NO: 0910-0430 EXPIRATION DATE: 02/28/2006
RESPS:3 HOURS:96 COSTS(000):$0
Guidance for Industry on Formal Dispute Resolutions; Appeals
Above the Division Level
FORMS: FDA-1571 FDA-356H
OMB NO: 0910-0431 EXPIRATION DATE: 03/31/2004
RESPS:12,278 HOURS:842,020 COSTS(000):$0
Changes to an Approved NDA or ANDA
FORMS: NONE
OMB NO: 0910-0433 EXPIRATION DATE: 02/29/2004
RESPS:548 HOURS:4,384 COSTS(000):$0
Postmarketing Studies for Human Drugs and Licensed Biological
Products; Status Reports
FORMS: FDA-2252
OMB NO: 0910-0435 EXPIRATION DATE: 05/31/2003
RESPS:96,935,065 HOURS:3,361,996 COSTS(000):$0
Prescription Drug Marketing Act of 1987; Policies, Requirements,
and Administrative Procedures
FORMS: NONE
OMB NO: 0910-0437 EXPIRATION DATE: 04/30/2003
RESPS:39,764 HOURS:91,306 COSTS(000):$0
Medical Devices; Medical Device Reporting;manufacturer
reportiing importer reporting, user facility reporting,
distributor reporting
FORMS: FDA-3419 FDA-3417
OMB NO: 0910-0439 EXPIRATION DATE: 04/30/2003
RESPS:265 HOURS:3,710 COSTS(000):$0
Aluminum in Large and Small Volume Parenterals Used in Total
Parenteral Nutrition
FORMS: NONE
OMB NO: 0910-0443 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:250 COSTS(000):$0
Survey of Incidence of Gastroenterolocial Parasitic Infections
in the United States as a Result of Consumption of Raw Fish
FORMS: NONE
OMB NO: 0910-0445 EXPIRATION DATE: 09/30/2003
RESPS:182 HOURS:51,688 COSTS(000):$0
Submitting and Reviewing Complete Responses to Clinical Holds;
Guidance for Industry
FORMS: NONE
OMB NO: 0910-0448 EXPIRATION DATE: 11/30/2003
RESPS:1,000 HOURS:1,000 COSTS(000):$0
Adoption of FDA Food Code by Local, State, and Tribal Governments
FORMS: NONE
OMB NO: 0910-0450 EXPIRATION DATE: 11/30/2003
RESPS:66 HOURS:27 COSTS(000):$0
Guidance for Industry on How to Use E-Mail to Submit a Notice of
Intent to Slaughter for Human Food Purposes
FORMS: 3487
OMB NO: 0910-0452 EXPIRATION DATE: 11/30/2003
RESPS:168 HOURS:116 COSTS(000):$0
Guidance for Industry on How to Use E-Mail to Submit a Request
for a Meeting or Teleconference to the Office of New Animal Drug
Evaluation
FORMS: FDA-3488
OMB NO: 0910-0453 EXPIRATION DATE: 11/30/2003
RESPS:324 HOURS:262 COSTS(000):$0
Guidance for Industry on How to Use E-Mail to Submit a Notice of
Final Disposition of Animals Not Inded for Immediate Slaughter
FORMS: FDA-3486
OMB NO: 0910-0454 EXPIRATION DATE: 11/30/2003
RESPS:140 HOURS:140 COSTS(000):$0
Guidance: How to Use E-Mail to Submit Information to the Center
for Veterinary Medicine
FORMS: NONE
OMB NO: 0910-0455 EXPIRATION DATE: 11/30/2003
RESPS:83 HOURS:1,529 COSTS(000):$1
Documentation for demonstrating compliance with the Channels
FORMS: NONE
OMB NO: 0910-0456 EXPIRATION DATE: 01/31/2004
RESPS:53 HOURS:343 COSTS(000):$0
PHS (Public Health Service) Guideline on Infectious Disease
Issues in Xenotransplantation
FORMS: NONE
OMB NO: 0910-0459 EXPIRATION DATE: 03/31/2004
RESPS:34,660 HOURS:202,496 COSTS(000):$0
Information Program on Clinical Trials for Serious and Life-
Threatening Diseases
FORMS: NONE
OMB NO: 0910-0461 EXPIRATION DATE: 02/29/2004
RESPS:10 HOURS:20 COSTS(000):$0
Substances Approved for Use in the Preparatin of Meat and
Poultry Products
FORMS: NONE
OMB NO: 0910-0466 EXPIRATION DATE: 03/31/2004
RESPS:15,035 HOURS:358,465 COSTS(000):$0
Hazard Analysis and Critical Control Point (HACCP) Procedures
for the Safe and Sanitary Processing of Juice (21 CFR Part 120)
FORMS: NONE
OMB NO: 0910-0467 EXPIRATION DATE: 04/30/2004
RESPS:6 HOURS:120 COSTS(000):$0
Request for Review of Scientific Disputes Concerning the
Regulation of Medical Devices
FORMS: NONE
OMB NO: 0910-0469 EXPIRATION DATE: 07/31/2004
RESPS:1,225 HOURS:1,525 COSTS(000):$0
Human Cells, Tissues, and Cellular and Tissue-Based Products;
Establishments Registration and Listing; Final Rule
FORMS: FDA-3356
OMB NO: 0910-0470 EXPIRATION DATE: 07/31/2004
RESPS:240 HOURS:3,180 COSTS(000):$0
Guidance for Industry on Special Protocol Assessment
FORMS: NONE
OMB NO: 0910-0471 EXPIRATION DATE: 07/31/2004
RESPS:1,245 HOURS:934 COSTS(000):$0
Adverse Event Pilot Program for Medical Devices
FORMS: NONE
OMB NO: 0910-0472 EXPIRATION DATE: 08/31/2004
RESPS:29,356 HOURS:3,125 COSTS(000):$0
Requirements for Testing Human Blood Donors for Evidence of
Infection Due to Communicable Disease Agents
FORMS: NONE
OMB NO: 0910-0474 EXPIRATION DATE: 08/31/2004
RESPS:416,021 HOURS:141,681 COSTS(000):$0
General Requirements for Blood, Blood Components, and Blood
Derivatives; Donor Notification
FORMS: NONE
OMB NO: 0910-0477 EXPIRATION DATE: 10/31/2004
RESPS:5,272 HOURS:659 COSTS(000):$0
Survey of Single-Use Medical Device (SUD) Reuse and Reprocessing
in Hospitals
FORMS: NONE
OMB NO: 0910-0478 EXPIRATION DATE: 05/31/2003
RESPS:5,000 HOURS:6,500 COSTS(000):$0
Consumer and Producer Surveys on Economic Issues
FORMS: NONE
OMB NO: 0910-0479 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:637 COSTS(000):$0
Assessment of Physician and Patient Attitudes Toward
Direct-to-Consumer (DTC) Promotion of Prescription Drugs
FORMS: NONE
OMB NO: 0910-0480 EXPIRATION DATE: 11/30/2003
RESPS:3 HOURS:17,403 COSTS(000):$56
Providing Regulatory Submissions in Electronic Format for Food
Additive and Color Additive Petitions
FORMS: FDA-3503 FDA-3504
OMB NO: 0910-0486 EXPIRATION DATE: 04/30/2005
RESPS:53 HOURS:813 COSTS(000):$1
Requirements for States as Certification Agencies
FORMS: NONE
OMB NO: 0910-0489 EXPIRATION DATE: 03/31/2005
RESPS:2,000 HOURS:922 COSTS(000):$0
Health and Diet Survey
FORMS: NONE
OMB NO: 0910-0492 EXPIRATION DATE: 01/31/2004
RESPS:7,000 HOURS:4,000 COSTS(000):$0
Consumer Surveys on Food and Dietary Supplement Labeling Issues
FORMS: NONE
OMB NO: 0910-0493 EXPIRATION DATE: 09/30/2005
RESPS:12 HOURS:960 COSTS(000):$0
Salmonella Discovery System Pilot Study
FORMS: NONE
OMB NO: 0910-0494 EXPIRATION DATE: 04/30/2003
RESPS:1,200 HOURS:300 COSTS(000):$0
The Evaluation of Long-Term Antibiotic Drug Therapy for Persons
Involved in Anthrax Remediation Activities
FORMS: NONE
OMB NO: 0910-0497 EXPIRATION DATE: 05/31/2004
RESPS:1,683 HOURS:3,352 COSTS(000):$0
Focus Groups as Used by the Food and Drug Administration
FORMS: NONE
OMB NO: 0910-0498 EXPIRATION DATE: 11/30/2005
RESPS:9,787 HOURS:13,287 COSTS(000):$766
Export Certificates for FDA Regulated Products Under U.S.C.
Sections 801(e) and 802
FORMS: NONE
OMB NO: 0910-0501 EXPIRATION DATE: 06/30/2004
RESPS:1 HOURS:112 COSTS(000):$0
Telephone Questionnaire Administration to Control Subjects
Recruited into FDA Lyme Vaccine Safety Study, "A Case-Control
Study of HLA Type and T-Cell Reactivity to Recombinat Outer.....
FORMS: NONE
OMB NO: 0915-0028 EXPIRATION DATE: 03/31/2004
RESPS:80 HOURS:14 COSTS(000):$0
Scholarship Program for Students of Exceptional Financial Need
(EFN) and Program of Financial Assistance for Disadvantages Heal
Professions Students (FADHPS) Application
FORMS: HRSA-525
OMB NO: 0915-0034 EXPIRATION DATE: 07/31/2003
RESPS:227,552 HOURS:13,703 COSTS(000):$0
Health Education Assistance Loan (HEAL) Program: Forms
FORMS: HRSA-504 HRSA-508
OMB NO: 0915-0036 EXPIRATION DATE: 08/31/2005
RESPS:26,700 HOURS:4,958 COSTS(000):$11
Health Education Assistance Loan (HEAL) Program: Lender's
Application for Insurance Claim Form and Request for Collection
Assistance Form
FORMS: 510 513
OMB NO: 0915-0043 EXPIRATION DATE: 10/31/2003
RESPS:12,088 HOURS:6,066 COSTS(000):$0
Health Education Assistance Loan (HEAL) Program Information
Collection Requirements - Forms
FORMS: HRSA-502-1 HRSA-502-2 HRSA-512
OMB NO: 0915-0081 EXPIRATION DATE: 07/31/2003
RESPS:14 HOURS:1 COSTS(000):$0
Black Lung Clinics Program (42 CFR 55a and Program Guidelines)
FORMS: NONE
OMB NO: 0915-0099 EXPIRATION DATE: 11/30/2003
RESPS:20 HOURS:60 COSTS(000):$0
Grants for Hospital Construction and Modernization - Federal
Rights of Recovery and Waiver of Recovery (42 CFR 124, Subpart H)
FORMS: NONE
OMB NO: 0915-0108 EXPIRATION DATE: 12/31/2003
RESPS:504,661 HOURS:95,290 COSTS(000):$0
Health Education Assistance Loan (HEAL) Program Regulation - 42
CFR Part 60
FORMS: NONE
OMB NO: 0915-0126 EXPIRATION DATE: 01/31/2004
RESPS:2,443,091 HOURS:304,398 COSTS(000):$13,508
National Practitioner Data Bank for Adverse Information on
Physicians and Other Health Care Practitioners: Regulations and
Forms
FORMS: NONE
OMB NO: 0915-0127 EXPIRATION DATE: 04/30/2005
RESPS:845 HOURS:1,211 COSTS(000):$0
The National Health Service Corps (NHSC) Loan Repayment Program
FORMS: NONE
OMB NO: 0915-0142 EXPIRATION DATE: 08/31/2005
RESPS:100 HOURS:4,000 COSTS(000):$1
Application for Certification as a Federall Qualified Health
Center Look-Alike
FORMS: NONE
OMB NO: 0915-0146 EXPIRATION DATE: 07/31/2003
RESPS:3,100 HOURS:3,100 COSTS(000):$8
The Application for Participation in the National Health Service
Corps Scholarship Program
FORMS: HRSA-856
OMB NO: 0915-0149 EXPIRATION DATE: 11/30/2003
RESPS:450 HOURS:12,600 COSTS(000):$0
Scholarships for Disadvantaged Students Applications
FORMS: NONE
OMB NO: 0915-0151 EXPIRATION DATE: 02/28/2005
RESPS:125 HOURS:2,375 COSTS(000):$0
Ryan White CARE Act Dental Reimbursement Program
FORMS: NONE
OMB NO: 0915-0157 EXPIRATION DATE: 06/30/2004
RESPS:517,693 HOURS:80,362 COSTS(000):$0
Organ Procurement and Transplantation Network and Scientific
Registry of Transplan Recipients Data System
FORMS: NONE
OMB NO: 0915-0158 EXPIRATION DATE: 12/31/2003
RESPS:278 HOURS:22,240 COSTS(000):$0
Grantee Reporting Requirements for the Ryan White Comprehensive
AIDS Resources Emergency Act of 1990 - Title III
FORMS: NONE
OMB NO: 0915-0172 EXPIRATION DATE: 04/30/2003
RESPS:59 HOURS:19,858 COSTS(000):$0
Maternal and Child Health Services Block Grant Annual Report,
Needs Assessment and Application Guidance
FORMS: NONE
OMB NO: 0915-0174 EXPIRATION DATE: 06/30/2003
RESPS:150 HOURS:150 COSTS(000):$0
Loan Information System Records for the DHHS and DHUD Hospital
Mortgage Insurance, Guarantee, and Direct Loan Programs
FORMS: HRSA-906
OMB NO: 0915-0176 EXPIRATION DATE: 10/31/2003
RESPS:9 HOURS:94 COSTS(000):$0
Drug Pricing Program Reporting Requirements
FORMS: NONE
OMB NO: 0915-0179 EXPIRATION DATE: 02/29/2004
RESPS:700 HOURS:700 COSTS(000):$0
Deferment Request Form for the National Health Service Corps
Scholarship Program
FORMS: NONE
OMB NO: 0915-0184 EXPIRATION DATE: 06/30/2004
RESPS:36,460 HOURS:4,862 COSTS(000):$0
Organ Procurement and Transplantation Network
FORMS: NONE
OMB NO: 0915-0185 EXPIRATION DATE: 04/30/2004
RESPS:550 HOURS:343 COSTS(000):$0
Pilot Test of the Community Health Center/National Health
Service Corp User/Visit Survey
FORMS: NONE
OMB NO: 0915-0186 EXPIRATION DATE: 01/31/2005
RESPS:2,785 HOURS:9,142 COSTS(000):$0
Main Study of the Community Health Center/National Health
Service Corps Site User/Visit Survey
FORMS: NONE
OMB NO: 0915-0188 EXPIRATION DATE: 10/31/2004
RESPS:265 HOURS:530 COSTS(000):$10
Data Collection and Reporting Requirements for Healty Schools,
Healthy Communities
FORMS: NONE
OMB NO: 0915-0193 EXPIRATION DATE: 11/30/2003
RESPS:757 HOURS:19,992 COSTS(000):$80,917
Uniform Data System
FORMS: NONE
OMB NO: 0915-0204 EXPIRATION DATE: 03/31/2004
RESPS:351 HOURS:88 COSTS(000):$2
Health Education Assistant Loan (HEAL) Program: Physicians's
Certification of Borrower's Total and Permanent Disability Form
FORMS: HRSA-539
OMB NO: 0915-0206 EXPIRATION DATE: 12/31/2003
RESPS:178 HOURS:9,714 COSTS(000):$403
Ryan White Comprehensive AIDS Resources Emergency Act of 1990,
Amended 1996 - Title IV
FORMS: NONE
OMB NO: 0915-0208 EXPIRATION DATE: 09/30/2003
RESPS:311 HOURS:26 COSTS(000):$0
Professional Training and Information Questionnaire
FORMS: HRSA-551 HRSA-552
OMB NO: 0915-0212 EXPIRATION DATE: 03/31/2006
RESPS:52,050 HOURS:5,075 COSTS(000):$0
Voluntary Partner Surveys to Implement Executive Order 12862 in
the Health Resources and Services Administration
FORMS: NONE
OMB NO: 0915-0219 EXPIRATION DATE: 11/30/2003
RESPS:864 HOURS:648 COSTS(000):$0
AIDS Drug Assistance Program Monthly Report for Ryan White
Comprehensive AIDS Resources Emergency Act Amendments of 1996,
Titles I and II
FORMS: NONE
OMB NO: 0915-0226 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:300 COSTS(000):$0
NHSC and Native Hawaiian Health Scholarship Programs Data
Collection Worksheet
FORMS: NONE
OMB NO: 0915-0232 EXPIRATION DATE: 04/30/2005
RESPS:900 HOURS:24,300 COSTS(000):$33
National Health Service Corps - Uniform Data System
FORMS: NONE
OMB NO: 0915-0233 EXPIRATION DATE: 04/30/2005
RESPS:150 HOURS:150 COSTS(000):$0
Disadvantaged Assistance Tracking and Outcome Report (DATOR) for
Health Careers Opportunity Program and Centers of Excellence
Program
FORMS: NONE
OMB NO: 0915-0239 EXPIRATION DATE: 03/31/2004
RESPS:1,282,004 HOURS:187,169 COSTS(000):$2,107
Healthcare Integrity and Protection Data Bank for Final Adverse
Information on Health Care Providers, Suppliers and
Practitioners (45 CFR 61)
FORMS: NONE
OMB NO: 0915-0244 EXPIRATION DATE: 12/31/2003
RESPS:2,025 HOURS:4,725 COSTS(000):$0
Ricky Ray Hemophilia Relief Fund Program
FORMS: NONE
OMB NO: 0915-0245 EXPIRATION DATE: 07/31/2003
RESPS:52,298 HOURS:26,149 COSTS(000):$0
They Ryan White CARE Act Client Demonstration Project Reporting
System
FORMS: NONE
OMB NO: 0915-0247 EXPIRATION DATE: 02/29/2004
RESPS:60 HOURS:3,600 COSTS(000):$0
Children's Hospital Graduate Medical Education Program
FORMS: NONE
OMB NO: 0915-0248 EXPIRATION DATE: 08/31/2003
RESPS:420 HOURS:139 COSTS(000):$0
The Impact of the State Child Health Insurance Program on
Selected Community Health Centers and Maternal and Child Health
Programs
FORMS: NONE
OMB NO: 0915-0250 EXPIRATION DATE: 02/29/2004
RESPS:1,350 HOURS:276 COSTS(000):$0
The National Health Service Corps Scholarship Program In-School
Worksheets
FORMS: NONE
OMB NO: 0915-0253 EXPIRATION DATE: 08/31/2004
RESPS:2,586 HOURS:96,600 COSTS(000):$0
Ryan White Comprehensive Aids Resources Emergency Act of 1990,
Cross-Title Data Report (CTDR) System
FORMS: NONE
OMB NO: 0915-0254 EXPIRATION DATE: 10/31/2004
RESPS:18,671 HOURS:13,440 COSTS(000):$0
U.S. Component of the 2001/2002 World Health Organization Study
of Health Behavior in School Children (WHO-HPSC)
FORMS: NONE
OMB NO: 0915-0256 EXPIRATION DATE: 09/30/2004
RESPS:5 HOURS:35 COSTS(000):$0
Charitable Facility Compliance Alternative (amended) - Final Rule
FORMS: NONE
OMB NO: 0915-0261 EXPIRATION DATE: 05/31/2005
RESPS:400 HOURS:400 COSTS(000):$0
Hepatitis B and C Among Health Care for the Homeless Program
Clients
FORMS: NONE
OMB NO: 0915-0262 EXPIRATION DATE: 06/30/2005
RESPS:212 HOURS:3,816 COSTS(000):$0
Office of State and National Partnership's Web-based Semi Annual
Report
FORMS: NONE
OMB NO: 0915-0263 EXPIRATION DATE: 07/31/2003
RESPS:52 HOURS:442 COSTS(000):$0
A Needs Assessment of the Black Lung Clinics Program
FORMS: NONE
OMB NO: 0915-0265 EXPIRATION DATE: 10/31/2003
RESPS:11,250 HOURS:1,000 COSTS(000):$0
Survey on Gender, Ethnic and Racial Backgrounds of Clients and
Staff at Bureau of Primary Health Care Supported Community-Based
Health Service Sites
FORMS: HRSA-105 HRSA-106
OMB NO: 0915-0266 EXPIRATION DATE: 11/30/2004
RESPS:743 HOURS:808 COSTS(000):$0
Private Health Insurance Coverage of Immunosuppressive Drugs
Survey
FORMS: NONE
OMB NO: 0915-0268 EXPIRATION DATE: 12/31/2005
RESPS:152 HOURS:1,216 COSTS(000):$0
Implementation of the Primary Care Surveillance System (PSCC)
Core Data Collection Effort for the Sentinal Centers Network
(SCN)
FORMS: NONE
OMB NO: 0915-0269 EXPIRATION DATE: 12/31/2004
RESPS:2,010 HOURS:505 COSTS(000):$0
Evaluation of the Health Care for the Homeless (HCH) Respite
Pilot Initiative
FORMS: NONE
OMB NO: 0915-0270 EXPIRATION DATE: 03/31/2006
RESPS:1,752 HOURS:483 COSTS(000):$0
Evaluation of the Infant Adoption Awareness Training Program
FORMS: NONE
OMB NO: 0915-0271 EXPIRATION DATE: 03/31/2004
RESPS:56 HOURS:168 COSTS(000):$0
Emergency Medical Services for Children (EMSC) Annual Grantee
Survey
FORMS: NONE
OMB NO: 0915-0272 EXPIRATION DATE: 01/31/2006
RESPS:750 HOURS:4,500 COSTS(000):$0
Maternal and Child Health Bureau Common Grant Guidance for
Discretionay Grants
FORMS: NONE
OMB NO: 0917-0007 EXPIRATION DATE: 12/31/2003
RESPS:261 HOURS:313 COSTS(000):$0
IHS Urban Indian Health Program Common Reporting Requirements
FORMS: NONE
OMB NO: 0917-0009 EXPIRATION DATE: 05/31/2003
RESPS:3,709 HOURS:2,371 COSTS(000):$0
IHS Medical Staff Credentials and Privileges File
FORMS: NONE
OMB NO: 0917-0014 EXPIRATION DATE: 12/31/2005
RESPS:2,125 HOURS:1,381 COSTS(000):$0
Indian Health Service Loan Repayment Program
FORMS: NONE
OMB NO: 0917-0022 EXPIRATION DATE: 07/31/2003
RESPS:475 HOURS:236 COSTS(000):$0
Evaluation of the Indian Health Service/Bureau of Indian Affairs
Training Practitioners Project
FORMS: NONE
OMB NO: 0917-0025 EXPIRATION DATE: 11/30/2003
RESPS:1 HOURS:384 COSTS(000):$0
Hoz'ho'nii: An Intervention to Increase Breast and Cervical
Cancer Screening Among Navajo Women
FORMS: NONE
OMB NO: 0917-0026 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:3,720 COSTS(000):$0
Final Rule to Implement Title V of the Tribal Self-Governance
Amendments of 2000
FORMS: NONE
OMB NO: 0917-0028 EXPIRATION DATE: 11/30/2005
RESPS:2,000 HOURS:500 COSTS(000):$20,000
IHS Background Investigatins of Individuals in Positins
Involving Regular Contact with or Control Over Indian Children
FORMS: OPM-306
OMB NO: 0917-0030 EXPIRATION DATE: 09/30/2003
RESPS:542,500 HOURS:174,375 COSTS(000):$0
IHS Forms To Implement The Privacy Rules (43 CFR Parts 160 and
164)
FORMS: NONE
OMB NO: 0920-0006 EXPIRATION DATE: 05/31/2005
RESPS:200 HOURS:167 COSTS(000):$0
Statements in Support of Application for Waiver of
Inadmissibility under Section 212(a)(1)(A)(i) or 212 (a)(1)(A)
(iii)(1) or (11)of Immigration and Nationality Act
FORMS: CDC-4.422-1 CDC-4.422-1A CDC-4.422-1B
OMB NO: 0920-0007 EXPIRATION DATE: 12/31/2003
RESPS:9,365 HOURS:4,927 COSTS(000):$0
Weekly and Annual Morbidity and Mortality Reports
FORMS: CDC-43.5A
OMB NO: 0920-0213 EXPIRATION DATE: 04/30/2003
RESPS:1,880 HOURS:418 COSTS(000):$0
National Vital Statistics Report Forms
FORMS: CDC-64.146 CDC-64.147
OMB NO: 0920-0214 EXPIRATION DATE: 04/30/2004
RESPS:39,000 HOURS:48,600 COSTS(000):$0
National Health Interview Survey: 2003 Basic Module with Topical
Modules
FORMS: NONE
OMB NO: 0920-0215 EXPIRATION DATE: 11/30/2004
RESPS:780 HOURS:227 COSTS(000):$0
Application Form and Related Forms for the Operation of the
National Death Index
FORMS: CDC/NCHS-6205-1 CDC-6425 CDC-6426 PHS-6205-3
OMB NO: 0920-0217 EXPIRATION DATE: 06/30/2004
RESPS:157 HOURS:44 COSTS(000):$0
NCHS Vital Statistics Training Form
FORMS: CDC-64.52
OMB NO: 0920-0263 EXPIRATION DATE: 02/28/2005
RESPS:100 HOURS:20 COSTS(000):$0
Requirements for a Special Permit to Import Cynomolgus, African
Green, and Rhesus Monkeys into the United States
FORMS: NONE
OMB NO: 0920-0274 EXPIRATION DATE: 08/31/2004
RESPS:4,548 HOURS:852 COSTS(000):$0
CDC Model Performance Evaluation Program (MPEP) for Retroviral
and AIDS-Related
FORMS: NONE
OMB NO: 0920-0278 EXPIRATION DATE: 04/30/2005
RESPS:145,688 HOURS:14,721 COSTS(000):$0
National Hospital Ambulatory Medical Care Survey
FORMS: 101(CDC-64.151) 101/U
OMB NO: 0920-0282 EXPIRATION DATE: 12/31/2003
RESPS:240 HOURS:480 COSTS(000):$0
CDC Childhood Lead Poisoning Prevention Program Quarterly Report
FORMS: NONE
OMB NO: 0920-0295 EXPIRATION DATE: 10/31/2005
RESPS:48,100 HOURS:1,342 COSTS(000):$0
National AIDS and STD Hotline Survey of Callers
FORMS: NONE
OMB NO: 0920-0314 EXPIRATION DATE: 09/30/2003
RESPS:52,000 HOURS:18,361 COSTS(000):$0
National Survey of Family Growth, Cycle 6 Main Study
FORMS: NONE
OMB NO: 0920-0322 EXPIRATION DATE: 02/28/2006
RESPS:300 HOURS:100 COSTS(000):$0
Cholera and other Vibrio Illness Surveillance Report
FORMS: 52.79
OMB NO: 0920-0337 EXPIRATION DATE: 06/30/2004
RESPS:188 HOURS:600 COSTS(000):$0
National Childhood blood Lead Surveillance System
FORMS: NONE
OMB NO: 0920-0338 EXPIRATION DATE: 10/31/2003
RESPS:7 HOURS:296 COSTS(000):$0
List of Ingredients Added to Tobacco in the Manufacture
FORMS: NONE
OMB NO: 0920-0353 EXPIRATION DATE: 10/31/2003
RESPS:62,000 HOURS:1,008 COSTS(000):$0
National Nursing Home Survey
FORMS: NONE
OMB NO: 0920-0401 EXPIRATION DATE: 06/30/2003
RESPS:4,500 HOURS:2,066 COSTS(000):$0
Longitudinal Studies of Chronic Fatigue Syndrome: Sedgwick
County Study 36-Month Follow-up
FORMS: NONE
OMB NO: 0920-0406 EXPIRATION DATE: 12/31/2004
RESPS:381,671 HOURS:150,606 COSTS(000):$0
State and Local Area Integrated Telephone Survey (SLAITS)
FORMS: NONE
OMB NO: 0920-0417 EXPIRATION DATE: 11/30/2003
RESPS:180,510 HOURS:37,397 COSTS(000):$10
National Surveillance System for Health Care Workers
FORMS: NONE
OMB NO: 0920-0427 EXPIRATION DATE: 04/30/2003
RESPS:500 HOURS:500 COSTS(000):$0
The Sentinel Surveillance for Chronic Liver Disease
FORMS: NONE
OMB NO: 0920-0428 EXPIRATION DATE: 02/28/2006
RESPS:16,994 HOURS:42,711 COSTS(000):$0
PHS Supplements to Application for Federal Assistance (SF 424)
FORMS: SF-424 PHS-5161-1 CDC.124(E) CDC.0113 OPHS-1
OMB NO: 0920-0442 EXPIRATION DATE: 12/31/2003
RESPS:223 HOURS:6,300 COSTS(000):$0
Surveillance for Bloodstream and Vascular Access Infections in
Outpatient Hemodialysis Centers
FORMS: NONE
OMB NO: 0920-0444 EXPIRATION DATE: 06/30/2005
RESPS:11 HOURS:18,766 COSTS(000):$0
Annual Submission of the Quantity of Nicotine Contained in
Smokeless Tobacco Products Manufactured, Imported, or Packaged
in the U.S.
FORMS: NONE
OMB NO: 0920-0449 EXPIRATION DATE: 09/30/2003
RESPS:13,000 HOURS:2,166 COSTS(000):$0
The Evaluation of Customer Satisfaction of the Internet Homepage
and Links for CDC and ATSDR
FORMS: NONE
OMB NO: 0920-0450 EXPIRATION DATE: 02/28/2006
RESPS:1,000 HOURS:1,625 COSTS(000):$0
Children's Longitudinal Development Study
FORMS: NONE
OMB NO: 0920-0461 EXPIRATION DATE: 04/30/2003
RESPS:3,130 HOURS:534 COSTS(000):$0
An Evaluation of Targeted Health Communication Messages: Folic
Acid and Neural Tube Defects
FORMS: NONE
OMB NO: 0920-0469 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:126 COSTS(000):$0
National Program of Cancer Registries - Cancer Surveillance
System
FORMS: NONE
OMB NO: 0920-0472 EXPIRATION DATE: 06/30/2003
RESPS:2,360 HOURS:510 COSTS(000):$0
Assessment of Exposure to Arsenic through Household Water
FORMS: NONE
OMB NO: 0920-0473 EXPIRATION DATE: 06/30/2003
RESPS:880 HOURS:218 COSTS(000):$0
Surveillance and Evaluation of Plasma Donors for the Human
Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV)
FORMS: NONE
OMB NO: 0920-0475 EXPIRATION DATE: 06/30/2003
RESPS:190 HOURS:55 COSTS(000):$0
Evaluation of the Public Health Prevention Service (PHPS) Program
FORMS: NONE
OMB NO: 0920-0479 EXPIRATION DATE: 07/31/2003
RESPS:118 HOURS:236 COSTS(000):$1
Implementation of an Automated Management Information System
FORMS: NONE
OMB NO: 0920-0480 EXPIRATION DATE: 07/31/2003
RESPS:138 HOURS:138 COSTS(000):$0
An evaluation study of Tuberculosis Control and Prevention
measures in Large City and County Jails
FORMS: NONE
OMB NO: 0920-0482 EXPIRATION DATE: 08/31/2003
RESPS:600 HOURS:200 COSTS(000):$0
Silicosis No Mas!: Evaluation of Materials Used for Outreach to
Hispanic Construction Workers
FORMS: NONE
OMB NO: 0920-0485 EXPIRATION DATE: 08/31/2003
RESPS:1,824 HOURS:1,425 COSTS(000):$0
Evaluating National Dissemination Strategies for Effective HIV
Prevention Programs for Youth
FORMS: NONE
OMB NO: 0920-0487 EXPIRATION DATE: 04/30/2003
RESPS:203 HOURS:55 COSTS(000):$0
Microbial Contamination of Produce: A Field Study in the Lower
Rio Grande Valley, Texas
FORMS: NONE
OMB NO: 0920-0488 EXPIRATION DATE: 09/30/2003
RESPS:16,500 HOURS:3,600 COSTS(000):$0
Restrictions on Interstate Travel of Persons
FORMS: NONE
OMB NO: 0920-0501 EXPIRATION DATE: 04/30/2003
RESPS:1,620 HOURS:485 COSTS(000):$0
A Research Program to Develop Optimal NIOSH Alerts for
Occupational Safety and Health in Farming
FORMS: NONE
OMB NO: 0920-0502 EXPIRATION DATE: 02/29/2004
RESPS:25,200 HOURS:7,918 COSTS(000):$0
Racial and Ethnic Approaches to Community Health (REACH)
FORMS: NONE
OMB NO: 0920-0503 EXPIRATION DATE: 02/29/2004
RESPS:11,300 HOURS:10,525 COSTS(000):$0
The Incidence of Breast and Other Cancers Among Female Flight
Attendants
FORMS: NONE
OMB NO: 0920-0504 EXPIRATION DATE: 02/29/2004
RESPS:40,236 HOURS:13,607 COSTS(000):$0
Thyroid Disease in Persons Exposed to Radioactive Fallout from
Atomic Weapons Testing at the Nevada Test Site: Phase III
FORMS: NONE
OMB NO: 0920-0508 EXPIRATION DATE: 03/31/2004
RESPS:4,000 HOURS:1,666 COSTS(000):$0
Evaluation Research for the National Bone Health Campaign
FORMS: NONE
OMB NO: 0920-0510 EXPIRATION DATE: 04/30/2003
RESPS:680 HOURS:230 COSTS(000):$0
Evaluating the Role of Positive and Negative Emotion in
Promoting Hearing Conservation Behaviors Among Coal Miners
FORMS: NONE
OMB NO: 0920-0511 EXPIRATION DATE: 04/30/2003
RESPS:6,435 HOURS:285 COSTS(000):$0
Developing Communication to Reduce Workplace Violence and
FORMS: NONE
OMB NO: 0920-0521 EXPIRATION DATE: 07/31/2003
RESPS:955 HOURS:455 COSTS(000):$0
National Survey of STD Services Provided to US College Students
FORMS: NONE
OMB NO: 0920-0525 EXPIRATION DATE: 10/31/2004
RESPS:980 HOURS:1,960 COSTS(000):$0
Assessing the Effectiveness of Community-Based Organizations for
Evaluation
FORMS: NONE
OMB NO: 0920-0526 EXPIRATION DATE: 11/30/2004
RESPS:2,456 HOURS:614 COSTS(000):$0
Evaluation of Viral Hepatitis B Educational Slide Materials
FORMS: NONE
OMB NO: 0920-0527 EXPIRATION DATE: 01/31/2005
RESPS:300 HOURS:350 COSTS(000):$0
Human Exposure to Cyanobacterial (Blue-green Algal) Toxins in
Drinking Water: Risk of Exposure to Microcystins from Public
Water Systems
FORMS: NONE
OMB NO: 0920-0530 EXPIRATION DATE: 05/31/2005
RESPS:15,000 HOURS:16,250 COSTS(000):$0
EEOICPA Dose Reconstruction Inerviews and Form
FORMS: OCAS-1
OMB NO: 0920-0533 EXPIRATION DATE: 04/30/2003
RESPS:900 HOURS:300 COSTS(000):$0
A Survey of Pediatricians' attitudes and practices about
promoting commmunication between parents and their children
about sexuality and sexual risk
FORMS: NONE
OMB NO: 0920-0535 EXPIRATION DATE: 09/30/2005
RESPS:1,152 HOURS:233 COSTS(000):$0
Evaluating Toolbox Training Safety Programs for Construction and
Mining
FORMS: NONE
OMB NO: 0920-0537 EXPIRATION DATE: 07/31/2003
RESPS:1,500 HOURS:3,000 COSTS(000):$0
Communicating NIOSH Safety Information to Youth
FORMS: NONE
OMB NO: 0920-0548 EXPIRATION DATE: 05/31/2005
RESPS:143 HOURS:48 COSTS(000):$0
National Telephone Survey of Urban Mosquito Control Programs
FORMS: NONE
OMB NO: 0920-0551 EXPIRATION DATE: 05/31/2005
RESPS:1,883 HOURS:1,993 COSTS(000):$0
NIOSH Research Study for the Prevention of Work-Related
Musculoskeletal Disorders
FORMS: NONE
OMB NO: 0920-0552 EXPIRATION DATE: 06/30/2005
RESPS:700 HOURS:140 COSTS(000):$0
Preventing Hearing Loss Among Construction Workers
FORMS: NONE
OMB NO: 0920-0555 EXPIRATION DATE: 07/31/2005
RESPS:1,167 HOURS:28,008 COSTS(000):$0
National Public Health Performance Standards Program Local
Public Health Performance Assessment
FORMS: NONE
OMB NO: 0920-0556 EXPIRATION DATE: 01/31/2006
RESPS:400 HOURS:63,400 COSTS(000):$1
Assisted Reproductive Technology (ART) Program Reporting System
FORMS: NONE
OMB NO: 0920-0557 EXPIRATION DATE: 07/31/2005
RESPS:20 HOURS:300 COSTS(000):$0
National Public Health Performance Standards Program State
Public Health Performance Assessment
FORMS: NONE
OMB NO: 0920-0558 EXPIRATION DATE: 08/31/2003
RESPS:1,870 HOURS:247 COSTS(000):$0
Development and Testing of a Tool to Assess the Pubic's
Perception About People with Epilepsy
FORMS: NONE
OMB NO: 0920-0559 EXPIRATION DATE: 08/31/2003
RESPS:416 HOURS:416 COSTS(000):$0
Dissemination of Lessons Learned from the Community Coalition
Partnership Programs for the Prevention of Teen Pregnancy
FORMS: NONE
OMB NO: 0920-0562 EXPIRATION DATE: 12/31/2003
RESPS:9,292 HOURS:6,969 COSTS(000):$0
National Suirvey of US Action Plan for Laboratory Containment of
Wild Polioviruses
FORMS: NONE
OMB NO: 0920-0563 EXPIRATION DATE: 11/30/2003
RESPS:11,050 HOURS:2,869 COSTS(000):$0
Survey to Assess Hepatitis B Vaccination Coverage Among U.S.
Health-Care Workers
FORMS: NONE
OMB NO: 0920-0564 EXPIRATION DATE: 09/30/2003
RESPS:5,000 HOURS:2,292 COSTS(000):$0
Joint Canadian US Survey of Health
FORMS: NONE
OMB NO: 0920-0565 EXPIRATION DATE: 10/31/2003
RESPS:1,200 HOURS:200 COSTS(000):$0
Reactions to Canadian Style Cigarette Warning Labels
FORMS: NONE
OMB NO: 0920-0566 EXPIRATION DATE: 10/31/2004
RESPS:8,000 HOURS:1,333 COSTS(000):$0
Evaluation of Worker Notification Program
FORMS: NONE
OMB NO: 0920-0567 EXPIRATION DATE: 10/31/2003
RESPS:268 HOURS:452 COSTS(000):$0
Evaluability Assessment of the Rape Prevention & Education Grant
Program
FORMS: NONE
OMB NO: 0920-0568 EXPIRATION DATE: 02/28/2005
RESPS:100 HOURS:100 COSTS(000):$0
Perceptions of Tuberculosis Among Foreign-Born Persons
FORMS: NONE
OMB NO: 0920-0571 EXPIRATION DATE: 04/30/2003
RESPS:273 HOURS:2,343 COSTS(000):$0
Minimum Data Elements (MDEs) System for Technical Assistance
Reporting (STAR) for the National Breast and Cervical Cancer
Early Detection Program (NBCCEDP)
FORMS: NONE
OMB NO: 0920-0572 EXPIRATION DATE: 01/31/2005
RESPS:7,018 HOURS:3,185 COSTS(000):$0
CDC and ATSDR Health Message Testing System and Smallpox
Knowledge Survey
FORMS: NONE
OMB NO: 0920-0573 EXPIRATION DATE: 11/30/2005
RESPS:79,981 HOURS:13,191 COSTS(000):$0
Adult and Pediatric Confidential HIV/AIDS Case Report
FORMS: CDC-50.42A CDC-50.42B
OMB NO: 0920-0574 EXPIRATION DATE: 12/31/2003
RESPS:12,000 HOURS:2,748 COSTS(000):$0
Impact of Community Coordinated Responses for the Prevention of
Intimate Partner Violence: A Random Digit Dial Survey
FORMS: NONE
OMB NO: 0920-0575 EXPIRATION DATE: 06/30/2003
RESPS:1,600 HOURS:533 COSTS(000):$0
Survey of Work-Relaed Assaults Treated in Hospital Emergency
Departments
FORMS: NONE
OMB NO: 0920-0576 EXPIRATION DATE: 08/31/2003
RESPS:15,853 HOURS:35,204 COSTS(000):$0
Possession, Use, and Transfer of Select Agents and Toxins (42
CFR Part 73)
FORMS: NONE
OMB NO: 0920-0577 EXPIRATION DATE: 02/29/2004
RESPS:3,698 HOURS:617 COSTS(000):$0
A and B Reader Surveys
FORMS: NONE
OMB NO: 0920-0580 EXPIRATION DATE: 02/28/2006
RESPS:1,067 HOURS:6,402 COSTS(000):$0
National Public Health Performance Standards Program Local
Public Health Governance Performance Assessment Tool
FORMS: NONE
OMB NO: 0920-0581 EXPIRATION DATE: 09/30/2004
RESPS:655 HOURS:185 COSTS(000):$0
Evaluation of the ACT Against Violence Training Program
FORMS: NONE
OMB NO: 0923-0002 EXPIRATION DATE: 08/31/2003
RESPS:36 HOURS:18 COSTS(000):$0
Information Collection Procedures for Requesting Public Health
Assessments
FORMS: NONE
OMB NO: 0923-0016 EXPIRATION DATE: 01/31/2006
RESPS:1,140 HOURS:285 COSTS(000):$0
Reader Evaluation of Public Health Assessments and other Products
FORMS: NONE
OMB NO: 0923-0023 EXPIRATION DATE: 04/30/2003
RESPS:4,334 HOURS:1,083 COSTS(000):$0
Exposure to Volatile Organic Compounds and Childhood Leukemia
Incidence at United States Marine Corps Base Camp Lejeune, North
Carolina
FORMS: NONE
OMB NO: 0925-0001 EXPIRATION DATE: 05/31/2004
RESPS:114,407 HOURS:1,376,468 COSTS(000):$480
Research and Research Training Grant Applications and Related
Forms
FORMS: PHS-398 PHS-2590 PHS-2271 PHS-3734 HHS-568
OMB NO: 0925-0002 EXPIRATION DATE: 06/30/2005
RESPS:32,228 HOURS:85,679 COSTS(000):$148
Individual National Research Service Award Applications and
Related Forms
FORMS: 416-5 416-7 416-9 6031 6031-1 PHS-416-1
OMB NO: 0925-0046 EXPIRATION DATE: 08/31/2003
RESPS:13,780 HOURS:2,010 COSTS(000):$0
Pretesting of Office of Cancer Communications Messages
FORMS: NONE
OMB NO: 0925-0177 EXPIRATION DATE: 07/31/2005
RESPS:1,630 HOURS:163 COSTS(000):$0
Special Volunteer and Guest Researcher Assignment
FORMS: NIH-590
OMB NO: 0925-0208 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:2,783 COSTS(000):$0
NCI Cancer Information Service Demographic/Customer Service Data
Collection
FORMS: NONE
OMB NO: 0925-0216 EXPIRATION DATE: 08/31/2004
RESPS:10,717 HOURS:8,639 COSTS(000):$0
The Framingham Study
FORMS: NONE
OMB NO: 0925-0240 EXPIRATION DATE: 04/30/2004
RESPS:9 HOURS:2,516 COSTS(000):$0
Drug Accountability Record
FORMS: NIH-2564 NIH-2564-1
OMB NO: 0925-0281 EXPIRATION DATE: 02/29/2004
RESPS:15,113 HOURS:3,746 COSTS(000):$0
The Atherosclerosis Risk in communities Study (ARIC)
FORMS: NONE
OMB NO: 0925-0299 EXPIRATION DATE: 02/28/2006
RESPS:21,545 HOURS:11,369 COSTS(000):$0
NIH Intramural Research Training Award Program Application
FORMS: NONE
OMB NO: 0925-0334 EXPIRATION DATE: 04/30/2004
RESPS:6,992 HOURS:1,719 COSTS(000):$0
The Cardiovascular Health Study
FORMS: NONE
OMB NO: 0925-0348 EXPIRATION DATE: 02/28/2005
RESPS:2 HOURS:360 COSTS(000):$0
Hazardous Waste Worker Training - 42 CFR Part 65
FORMS: NONE
OMB NO: 0925-0361 EXPIRATION DATE: 12/31/2004
RESPS:8,045 HOURS:12,611 COSTS(000):$0
National Institutes of Health Loan Repayment Programs
FORMS: NIH-2674-1 NIH-2674-2 NIH-2674-3 NIH-2674-4 NIH-2674-5
NIH-2674-6 NIH-2674-7 NIH-2674-8 NIH-2674-9 NIH-2674-10--12
OMB NO: 0925-0368 EXPIRATION DATE: 01/31/2004
RESPS:265,000 HOURS:30,979 COSTS(000):$0
Tobacco Use Supplement to the Current Population Survey: 2003
Tobacco Use Special Cessation Supplement to CPS
FORMS: NONE
OMB NO: 0925-0378 EXPIRATION DATE: 06/30/2004
RESPS:200 HOURS:125 COSTS(000):$0
Application for the Pharmacology Research Associate Program
FORMS: NIH-2721-1 NIH-2721-2
OMB NO: 0925-0406 EXPIRATION DATE: 11/30/2003
RESPS:25,012 HOURS:13,433 COSTS(000):$0
Agricultural health Study (A Prospective Cohort Study of Cancer
and Other Diseases Among Men and Women in Agriculture) -
Validation Sub-Study on Rheumatoid Arthritis
FORMS: NONE
OMB NO: 0925-0407 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:39,597 COSTS(000):$0
Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening
Trial
FORMS: NONE
OMB NO: 0925-0414 EXPIRATION DATE: 05/31/2003
RESPS:85,011 HOURS:36,467 COSTS(000):$0
Women's Health Initiative Observational Study
FORMS: NONE
OMB NO: 0925-0417 EXPIRATION DATE: 08/31/2005
RESPS:42,800 HOURS:232,080 COSTS(000):$4
Responsibility of Applicants for Promoting Objectivity in
Research for Which Public Health Service Funding is Sought and
Responsible Prospective Contractors--42 CFR Part 50,....
FORMS: NONE
OMB NO: 0925-0423 EXPIRATION DATE: 12/31/2003
RESPS:150,166 HOURS:55,977 COSTS(000):$0
A Prospective Study of Diet and Cancer in Members of the
American Association of Retired Persons (AARP)
FORMS: NONE
OMB NO: 0925-0424 EXPIRATION DATE: 03/31/2005
RESPS:16,481 HOURS:16,481 COSTS(000):$0
National Institutes of Health Construction Grants - 42 CFR Part
52b (Final Rule)
FORMS: NONE
OMB NO: 0925-0438 EXPIRATION DATE: 07/31/2004
RESPS:1,330 HOURS:1,727 COSTS(000):$0
National Institutes of Health Undergraduate Scholarship Program
for Individuals from Disadvantaged Backgrounds
FORMS: NIH-2762-1 NIH-2762-2 NIH-2762-3 NIH-2762-4 NIH-2762-5
OMB NO: 0925-0449 EXPIRATION DATE: 10/31/2003
RESPS:600 HOURS:2,250 COSTS(000):$0
Alcoholism Prevalence and Gene/Environment Interactions in
American Indian Tribes, 10 Tribe Study
FORMS: NONE
OMB NO: 0925-0454 EXPIRATION DATE: 07/31/2004
RESPS:590 HOURS:216 COSTS(000):$0
Case-Cohort Study of Cancer and Related Disorders Among
Benzene-Exposed Workers in China
FORMS: NONE
OMB NO: 0925-0458 EXPIRATION DATE: 03/31/2004
RESPS:5,604 HOURS:1,776 COSTS(000):$0
Generic Clearance for Satisfaction Surveys of Customers and
Other Partners
FORMS: NONE
OMB NO: 0925-0466 EXPIRATION DATE: 04/30/2004
RESPS:14,390 HOURS:7,774 COSTS(000):$0
Evaluation of the National Youth Anti-Drug Media Campaign
(NYAMC): Revision
FORMS: NONE
OMB NO: 0925-0467 EXPIRATION DATE: 09/30/2005
RESPS:15,728 HOURS:7,864 COSTS(000):$0
Young Drivers Intervention Study
FORMS: NONE
OMB NO: 0925-0475 EXPIRATION DATE: 03/31/2005
RESPS:87 HOURS:40 COSTS(000):$0
Training Tomorrow's Scientists: Linking Minorities and Mentors
Through the Web
FORMS: NONE
OMB NO: 0925-0476 EXPIRATION DATE: 04/30/2003
RESPS:18,400 HOURS:2,263 COSTS(000):$0
Request for Generic Clearance to Conduct Voluntary
Customer/Partner Surveys
FORMS: NONE
OMB NO: 0925-0478 EXPIRATION DATE: 06/30/2003
RESPS:55,000 HOURS:11,962 COSTS(000):$0
2000 California Health Interview Survey, Cancer Control Tropical
Module (CHIS, CCTM)
FORMS: NONE
OMB NO: 0925-0479 EXPIRATION DATE: 06/30/2003
RESPS:62 HOURS:16 COSTS(000):$0
Request for Clearance to Conduct Voluntary Customer Satisfaction
Surveys
FORMS: NONE
OMB NO: 0925-0482 EXPIRATION DATE: 02/29/2004
RESPS:5,277 HOURS:1,867 COSTS(000):$0
The Family Health Study (Validation of a Family History of
Cancer Questionnaire for Risk Factor Surveillance)
FORMS: NONE
OMB NO: 0925-0483 EXPIRATION DATE: 03/31/2006
RESPS:1,233 HOURS:205 COSTS(000):$0
Environmental Factors in the Development of Polycystic Ovary
Syndrome
FORMS: NONE
OMB NO: 0925-0484 EXPIRATION DATE: 03/31/2004
RESPS:48,000 HOURS:48,000 COSTS(000):$0
National Epidemiologic Survey on Alcohol and Related Conditions
FORMS: N/A
OMB NO: 0925-0486 EXPIRATION DATE: 04/30/2004
RESPS:104,000 HOURS:8,684 COSTS(000):$0
Evaluation of User Satisfaction with NIH Internet Sites
FORMS: NONE
OMB NO: 0925-0488 EXPIRATION DATE: 05/31/2003
RESPS:400 HOURS:233 COSTS(000):$0
Survey of IRB Chairs Concerning the Implementatin of Pediatric
Research Regulation
FORMS: NONE
OMB NO: 0925-0489 EXPIRATION DATE: 06/30/2004
RESPS:200 HOURS:100 COSTS(000):$0
Customer/Partner Satisfaction Survey of the NIDCD Minority and
Disability Supplement Program
FORMS: NONE
OMB NO: 0925-0491 EXPIRATION DATE: 07/31/2004
RESPS:480 HOURS:160 COSTS(000):$0
The Jackson Heart Study: Annual Follow-up with Third Party
Respondents
FORMS: NONE
OMB NO: 0925-0492 EXPIRATION DATE: 10/31/2003
RESPS:1 HOURS:60 COSTS(000):$0
Validation of Questionnaires Used for Occupational Exposure
Assessment in Case-Control Studies: Occupational History
Questionnaire with Foundry Worker & Textile Industry Job Modules
FORMS: NONE
OMB NO: 0925-0493 EXPIRATION DATE: 09/30/2004
RESPS:555 HOURS:42 COSTS(000):$0
Multi-Ethnic Study of Atherosclerosis (MESA) Event Surveillance
FORMS: NONE
OMB NO: 0925-0494 EXPIRATION DATE: 10/31/2003
RESPS:340 HOURS:340 COSTS(000):$0
A Nested Case-Control Study of Lung Cancer and Diesel Exhaust
Among Non-Metal Miners
FORMS: NONE
OMB NO: 0925-0495 EXPIRATION DATE: 10/31/2004
RESPS:700 HOURS:400 COSTS(000):$0
Leukemia and Other Hematological Diseases Among Cleanup Workers
in Ukraine Following the Chornobyl Accident
FORMS: NONE
OMB NO: 0925-0496 EXPIRATION DATE: 10/31/2003
RESPS:6,223 HOURS:1,556 COSTS(000):$0
Extended Lung Cancer Incidence Follow-Up for the Mayo Lung
Project Participants (MLP-EI)
FORMS: NONE
OMB NO: 0925-0498 EXPIRATION DATE: 04/30/2005
RESPS:520 HOURS:520 COSTS(000):$0
Study of Testicular Germ Cell Cancer in U.S. Military
Servicemen: Sub-study of Maternal Risk Factors
FORMS: NONE
OMB NO: 0925-0499 EXPIRATION DATE: 04/30/2003
RESPS:1,000 HOURS:500 COSTS(000):$0
The National Survey to Evaluate the NIH SBIR Program
FORMS: NONE
OMB NO: 0925-0500 EXPIRATION DATE: 06/30/2005
RESPS:2,415 HOURS:746 COSTS(000):$0
National Cancer Institute Cancer Information Service Evaluation
Surveys
FORMS: NONE
OMB NO: 0925-0502 EXPIRATION DATE: 05/31/2003
RESPS:448 HOURS:112 COSTS(000):$0
A Follow-up Survey of National Cancer Institute Science
Enrichment Program Students
FORMS: NONE
OMB NO: 0925-0503 EXPIRATION DATE: 06/30/2005
RESPS:300 HOURS:300 COSTS(000):$0
Assessment of the Use of Special Funding for Research on Type 1
Diabetes Provided by the Balanced Budget Act of 1997 and the FY
2001 Consolidated Appropriations Act
FORMS: NONE
OMB NO: 0925-0504 EXPIRATION DATE: 07/31/2003
RESPS:620 HOURS:318 COSTS(000):$0
Evaluation of the NCI State-of-the-Science Web Site
FORMS: NONE
OMB NO: 0925-0506 EXPIRATION DATE: 10/31/2003
RESPS:50,000 HOURS:10,700 COSTS(000):$0
Retrovirus Epidemiology Donor Study (REDS): A Study of
Motivations and Deterrents to Blood Donation in the United States
FORMS: NONE
OMB NO: 0925-0507 EXPIRATION DATE: 08/31/2003
RESPS:11,350 HOURS:4,049 COSTS(000):$0
Health Information National Trends Survey (HINTS)
FORMS: NONE
OMB NO: 0925-0510 EXPIRATION DATE: 04/30/2003
RESPS:600 HOURS:300 COSTS(000):$0
An Evaluation of the National Cancer Institute Science
Enrichment Program
FORMS: NONE
OMB NO: 0925-0512 EXPIRATION DATE: 12/31/2005
RESPS:15,035 HOURS:1,593 COSTS(000):$0
Behavioral and Environmental Risk Factors for Childhood Drowning
FORMS: NONE
OMB NO: 0925-0513 EXPIRATION DATE: 10/31/2004
RESPS:7,000 HOURS:1,750 COSTS(000):$0
HIV Vaccine Awareness Study - Americans' Attitudes
FORMS: NONE
OMB NO: 0925-0514 EXPIRATION DATE: 10/31/2004
RESPS:8,000 HOURS:2,820 COSTS(000):$0
California Health Interview Survey - Complementary and
Alternative Medicine (CHIS-CAM)
FORMS: NONE
OMB NO: 0925-0515 EXPIRATION DATE: 01/31/2005
RESPS:2,600 HOURS:762 COSTS(000):$0
National Kidney Disease Education Program Evaluation Survey
FORMS: NONE
Substance Abuse and Mental Health Services Administration
OMB NO: 0930-0074 EXPIRATION DATE: 03/31/2004
RESPS:900 HOURS:176 COSTS(000):$0
Obligated Service for Mental Health Traineeships: Regulations
and Forms
FORMS: SMA-111 SMA-111-1 SMA-111-2
OMB NO: 0930-0080 EXPIRATION DATE: 07/31/2004
RESPS:60 HOURS:34,640 COSTS(000):$0
Substance Abuse Prevention and Treatment Block Grant Application
Format - FY2002-2004
FORMS: NONE
OMB NO: 0930-0092 EXPIRATION DATE: 07/31/2004
RESPS:1,485,000 HOURS:259,876 COSTS(000):$73
Confidentiality of Alcohol and Drug Abuse Patient Records - 42
CFR Part 2
FORMS: NONE
OMB NO: 0930-0093 EXPIRATION DATE: 10/31/2003
RESPS:52 HOURS:104 COSTS(000):$0
Annual Census of Patient Characteristics in State and County
Mental Hospital Inpatient Services
FORMS: SMA-102
OMB NO: 0930-0104 EXPIRATION DATE: 06/30/2004
RESPS:16 HOURS:7 COSTS(000):$0
Community Mental Health Centers Construction Grantee Checklist -
Form and Regulations
FORMS: SMA-101
OMB NO: 0930-0106 EXPIRATION DATE: 12/31/2005
RESPS:24,305 HOURS:14,158 COSTS(000):$0
Drug and Alcohol Services Information System (DASIS)
FORMS: NONE
OMB NO: 0930-0110 EXPIRATION DATE: 01/31/2004
RESPS:183,690 HOURS:84,188 COSTS(000):$0
2003 National Survey on Drug Use and Health
FORMS: NONE
OMB NO: 0930-0119 EXPIRATION DATE: 07/31/2005
RESPS:4,186 HOURS:4,093 COSTS(000):$0
2002 Survey of Mental Health Organizations, General Hospital
Mental Health Services, and Managed Care Organizations (SMHO)
FORMS: NONE
OMB NO: 0930-0158 EXPIRATION DATE: 06/30/2003
RESPS:7,093,210 HOURS:1,790,664 COSTS(000):$2,016
Mandatory guidelines for Federal Workplace Drug Testing Program
FORMS: NONE
OMB NO: 0930-0163 EXPIRATION DATE: 02/29/2004
RESPS:60 HOURS:961 COSTS(000):$0
Substance Abuse Prevention and Treatment Block Grant
Regulations- 45 CFR Part 96
FORMS: NONE
OMB NO: 0930-0168 EXPIRATION DATE: 07/31/2004
RESPS:59 HOURS:16,360 COSTS(000):$0
FY 2002-2004 Community Mental Health Services Block Grant
Application: Voluntary Format and Content
FORMS: NONE
OMB NO: 0930-0169 EXPIRATION DATE: 03/31/2004
RESPS:114 HOURS:2,166 COSTS(000):$0
Protection and Advocacy of Individuals with Mental Illness
(PAIMI) Annual Program Performance Report
FORMS: NONE
OMB NO: 0930-0172 EXPIRATION DATE: 02/29/2004
RESPS:136 HOURS:168 COSTS(000):$0
Protection and Advocacy Program for Individuals with Mental
Illness Regulations -- 45 CFR Part 51
FORMS: NONE
OMB NO: 0930-0192 EXPIRATION DATE: 12/31/2005
RESPS:11,255 HOURS:14,164 COSTS(000):$0
National Evaluation of the Comprehensive Community Mental Health
Services for Children and Their Families Program: Phase Two
FORMS: NONE
OMB NO: 0930-0195 EXPIRATION DATE: 09/30/2004
RESPS:12,901 HOURS:2,252 COSTS(000):$0
Participant Feedback for the Mental Health Care Provider
Education in HIV/AIDS Program II and III
FORMS: NONE
OMB NO: 0930-0197 EXPIRATION DATE: 12/31/2004
RESPS:30,150 HOURS:10,375 COSTS(000):$0
Voluntary Customer Satisfaction Surveys to Implement Executive
Order 12862 in the Substance Abuse and Mental Health Services
Administration (SAMHSA)
FORMS: NONE
OMB NO: 0930-0203 EXPIRATION DATE: 04/30/2005
RESPS:10 HOURS:23 COSTS(000):$0
Assessment of the National Leadership Institute (NLI) Program
and Services and the Minority Community-based Organization
(MCBO) Program
FORMS: NONE
OMB NO: 0930-0205 EXPIRATION DATE: 01/31/2006
RESPS:454 HOURS:13,794 COSTS(000):$0
Annual Reports for Projects for Assistance in Transition from
Homelessness (PATH)
FORMS: NONE
OMB NO: 0930-0206 EXPIRATION DATE: 09/30/2003
RESPS:8,321 HOURS:1,944 COSTS(000):$1,796
Opiod Drugs in Maintenance and Detoxification Treatment of
Opiate Dependence - 42 CFR Part 8
FORMS: SMA-162 SMA-163 SMA-168
OMB NO: 0930-0208 EXPIRATION DATE: 12/31/2005
RESPS:139,793 HOURS:25,543 COSTS(000):$0
SAMHSA Government Performance and Results Act (GPRA) Client
Outcome Measures for Discretionary Programs
FORMS: NONE
OMB NO: 0930-0209 EXPIRATION DATE: 05/31/2003
RESPS:93,826 HOURS:20,046 COSTS(000):$0
National Evaluation of the Comprehensive Community Mental Health
Services for Children and Their Families Program: Phase Three
FORMS: NONE
OMB NO: 0930-0210 EXPIRATION DATE: 05/31/2003
RESPS:260 HOURS:315 COSTS(000):$0
Registration Form for the National Registry of Effective
Prevention Programs
FORMS: NONE
OMB NO: 0930-0213 EXPIRATION DATE: 06/30/2003
RESPS:24,525 HOURS:17,959 COSTS(000):$0
State Prevention Needs Assessment Surveys: Alcohol and
FORMS: NONE
OMB NO: 0930-0216 EXPIRATION DATE: 09/30/2003
RESPS:48,247 HOURS:6,393 COSTS(000):$0
National Cross-Site Assessment of Addiction Technology Transfer
Centers (ATTC) Network
FORMS: NONE
OMB NO: 0930-0217 EXPIRATION DATE: 01/31/2004
RESPS:10 HOURS:100 COSTS(000):$0
Administrative Reporting Form for the "Women, Co-occurring
Disorders and Violence Cooperative Agreement Program (Phase II)"
FORMS: NONE
OMB NO: 0930-0222 EXPIRATION DATE: 07/31/2004
RESPS:59 HOURS:1,947 COSTS(000):$0
Substance Abuse Prevention and Treatment Block Grant Synar
Report Format, FY 2002-2004
FORMS: NONE
OMB NO: 0930-0223 EXPIRATION DATE: 09/30/2004
RESPS:2,280 HOURS:2,503 COSTS(000):$0
Evaluation of the CMHS/CSAT Collaborative Program on Homeless
Families: Women with Psychiatric, Substance Use, or Co-occuring
Disorders and Their Dependent Children
FORMS: NONE
OMB NO: 0930-0226 EXPIRATION DATE: 07/31/2004
RESPS:313 HOURS:1,204 COSTS(000):$0
Protocols for the Cross-Site Process Evaluation of the State
FORMS: NONE
OMB NO: 0930-0230 EXPIRATION DATE: 01/31/2005
RESPS:404 HOURS:1,212 COSTS(000):$0
Core Measures for the Center for Substance Abuse Prevention
FORMS: NONE
OMB NO: 0930-0231 EXPIRATION DATE: 02/28/2005
RESPS:721 HOURS:577 COSTS(000):$0
National Survey on Drug Use and Health: Clinical Validation
Study of Substance Abuse and Dependence Measures
FORMS: NONE
OMB NO: 0930-0232 EXPIRATION DATE: 02/28/2005
RESPS:5,160 HOURS:1,210 COSTS(000):$0
Workplace Helpline Call Record Form and Technical Assistance
Follow-up Survey Form
FORMS: NONE
OMB NO: 0930-0234 EXPIRATION DATE: 12/31/2005
RESPS:1,233 HOURS:103 COSTS(000):$0
Notification of Intent to Use Schedule III, IV, or V Opioid
Drugs for the Maintenance and Detoxification Treatment of Opiate
Addiction under 21 USC / 823(g)(2)
FORMS: SMA-167
OMB NO: 0930-0236 EXPIRATION DATE: 12/31/2003
RESPS:274 HOURS:224 COSTS(000):$0
An Assessment of the Status of PASRR and Mental Health Services
for Persons in Nursing Facilities
FORMS: NONE
OMB NO: 0930-0238 EXPIRATION DATE: 08/31/2004
RESPS:18,488 HOURS:6,878 COSTS(000):$0
State Treatment Needs Assessment Program (STNAP)
FORMS: NONE
OMB NO: 0930-0240 EXPIRATION DATE: 12/31/2005
RESPS:25,345 HOURS:7,141 COSTS(000):$0
Evaluation of the Center for Substance Abuse Prevention's
Underage Drinking Prevention Public Education Program
FORMS: NONE
OMB NO: 0930-0241 EXPIRATION DATE: 10/31/2005
RESPS:3,200 HOURS:2,804 COSTS(000):$0
Survey of the Characteristics and Funding of School Mental
Health Services
FORMS: NONE
OMB NO: 0930-0243 EXPIRATION DATE: 03/31/2006
RESPS:3,240 HOURS:1,080 COSTS(000):$0
Prevention Program Outcomes Monitoring System
FORMS: NONE
OMB NO: 0935-0113 EXPIRATION DATE: 08/31/2003
RESPS:1,125 HOURS:281 COSTS(000):$35,000
Enrolle Survey of Relationship Between Out-of-Pocket Costs and
Use of Prescribed Medications
FORMS: NONE
OMB NO: 0935-0114 EXPIRATION DATE: 01/31/2004
RESPS:280 HOURS:124 COSTS(000):$50,000
Pilot Study of Hospital Adverse Event Reporting Survey
FORMS: NONE
OMB NO: 0935-0115 EXPIRATION DATE: 01/31/2004
RESPS:900 HOURS:300 COSTS(000):$50,000
Pilot Data for the Development of Hospital Patient Safety
Culture Survey
FORMS: NONE
OMB NO: 0937-0025 EXPIRATION DATE: 07/31/2003
RESPS:10,000 HOURS:4,000 COSTS(000):$0
Application for Appointment as a Commissioned Officer in U.S.
Public Health Service Commissioned Corps (and) Reference Request
for Applicants to the USPHS Commissioned Corps
FORMS: PHS-50 PHS-1813
OMB NO: 0937-0095 EXPIRATION DATE: 09/30/2005
RESPS:10 HOURS:40 COSTS(000):$0
Application to the Board of Correction of Public Health Service
Commissioned Corps Records
FORMS: PSC-54
OMB NO: 0937-0166 EXPIRATION DATE: 05/31/2003
RESPS:50,000 HOURS:50,000 COSTS(000):$0
42 CFR Part B: Sterilization of Persons in Federally Assisted
Family Planning Projects
FORMS: NONE
OMB NO: 0937-0191 EXPIRATION DATE: 07/31/2004
RESPS:32 HOURS:6,400 COSTS(000):$226
Application Packets for Real Property for Public Health Purposes
FORMS: HHS-696
OMB NO: 0937-0198 EXPIRATION DATE: 01/31/2006
RESPS:3,300 HOURS:3,721 COSTS(000):$0
Responsibilities of Awardees and Applicant Institutions for
Reporting Possible Misconduct in Science (42 CFR Part 50)
FORMS: PHS-6349
OMB NO: 0937-0200 EXPIRATION DATE: 02/29/2004
RESPS:61,300 HOURS:184,200 COSTS(000):$0
HHS Payment Management System Forms
FORMS: SF-270 SF-272
OMB NO: 0938-0008 EXPIRATION DATE: 03/31/2006
RESPS:740,215,135 HOURS:44,189,007 COSTS(000):$0
Health Insurance Common Claims Formand Supporting Regulations:
42 CFR 414.40, 424.32, 424.44
FORMS: CMS-1490S CMS-1490U CMS-1500
OMB NO: 0938-0022 EXPIRATION DATE: 05/31/2004
RESPS:7,310 HOURS:1,311,060 COSTS(000):$0
Home Health Agency Cost Report and Supporting Regulations in 42
CFR 413.20, 413.24, 413.106
FORMS: HCFA-1728-94
OMB NO: 0938-0023 EXPIRATION DATE: 07/31/2005
RESPS:2,000 HOURS:500 COSTS(000):$0
Attending Physicians Statement and Documentation of Medicare
Emergency and Supporting Regulations in 42 CFR, Section 424.103
FORMS: CMS-1771
OMB NO: 0938-0025 EXPIRATION DATE: 10/31/2003
RESPS:14,000 HOURS:5,833 COSTS(000):$0
Request for Termination of Premium-Hospital and/or Supplementary
Medical Insurance and Supporting Regulations in 42 CFR 406.28
and 407.27
FORMS: HCFA-1763
OMB NO: 0938-0027 EXPIRATION DATE: 09/30/2005
RESPS:98 HOURS:172 COSTS(000):$0
The Request for Certification as a Supplier of Portable X-Ray
and Portable X-Ray Survey Report form under the
Medicare/Medicaid Program - Portable X-Ray Survey Report &
Supporting Regulations..
FORMS: CMS-1880 CMS-1882
OMB NO: 0938-0034 EXPIRATION DATE: 10/31/2003
RESPS:55,000 HOURS:9,167 COSTS(000):$0
Request for Hearing for Part B Medicare Claim and Supporting
Regulations in 42 CFR, 405.821
FORMS: HCFA-1965
OMB NO: 0938-0035 EXPIRATION DATE: 06/30/2003
RESPS:2,000 HOURS:716 COSTS(000):$0
SSO Report of State Buy-in Problems, 42 CFR 407.40
FORMS: HCFA-1957
OMB NO: 0938-0037 EXPIRATION DATE: 02/28/2005
RESPS:716 HOURS:71,600 COSTS(000):$0
Outpatient Rehabilitation Cost Report and Supporting Regulations
in 42 CFR 413.20 and 413.24
FORMS: CMS-2088-92
OMB NO: 0938-0041 EXPIRATION DATE: 10/31/2003
RESPS:15,000 HOURS:6,250 COSTS(000):$0
Third Party Premium Billing Request and Supporting Regulations
in 42 CFR 408.6
FORMS: HCFA-2384
OMB NO: 0938-0042 EXPIRATION DATE: 03/31/2004
RESPS:9,301,183 HOURS:390,418 COSTS(000):$0
Request for Medicare Payment - Ambulance and Supporting
Regulations in 42 CFR Section 410.40 and 424.124
FORMS: HCFA-1491
OMB NO: 0938-0045 EXPIRATION DATE: 10/31/2003
RESPS:62,000 HOURS:15,500 COSTS(000):$0
Request for Reconsideration of Part A Medicare Claim and
Supporting Regulations in 42 CFR, 405.711
FORMS: HCFA-2649
OMB NO: 0938-0046 EXPIRATION DATE: 08/31/2004
RESPS:60,000 HOURS:25,000 COSTS(000):$0
End Stage Renal Disease Medical Evidence Report Medicare
Entitlement and/or Patient Registration and Supporting
Regulations in 42 CFR, 405.2133
FORMS: HCFA-2728(ESRD)
OMB NO: 0938-0050 EXPIRATION DATE: 11/30/2005
RESPS:6,010 HOURS:3,980,522 COSTS(000):$0
Hospital and Health Care Complexes Cost Report and Supporting
Regulations in 42 CFR 413.20 and 413.24
FORMS: CMS-2552-96
OMB NO: 0938-0062 EXPIRATION DATE: 11/30/2003
RESPS:6,763 HOURS:20,289 COSTS(000):$0
Intermediate Care Facility for the Mentally Retarded or Persons
with Related Conditions ICF/MR Survey Report Form (3070G-1) and
Suppporting Regulations at 42CFR 431.52, 431.151, 435.1009,....
FORMS: HCFA-3070-G-1
OMB NO: 0938-0065 EXPIRATION DATE: 10/31/2005
RESPS:255 HOURS:446 COSTS(000):$0
Request for Certification in the Medicare and/or Medicaid
Program to Provide Outpatient Physical Therapy and/or Speech
Pathology Services, Outpatient Physical Therapy Speech......
FORMS: CMS-1856 CMS-1893
OMB NO: 0938-0067 EXPIRATION DATE: 04/30/2005
RESPS:224 HOURS:18,144 COSTS(000):$0
Quarterly Medicaid Statement of Expenditures for the Medical
Assistance Program
FORMS: HCFA-64
OMB NO: 0938-0074 EXPIRATION DATE: 12/31/2005
RESPS:661 HOURS:1,157 COSTS(000):$0
Request for Certification as Rural Health Clinic and Rural
Health Clinic Survey Report Form and Supporting Regulations in
42 CFR 491.1-491.11
FORMS: CMS-0029/0030
OMB NO: 0938-0080 EXPIRATION DATE: 07/31/2003
RESPS:90,000 HOURS:26,000 COSTS(000):$0
Application for Health Insurance Benefits Under Medicare for
Individual with Chronic Renal Disease and Supporting Regulations
in 42 CFR 406.13
FORMS: HCFA-43
OMB NO: 0938-0086 EXPIRATION DATE: 10/31/2005
RESPS:125,000 HOURS:62,500 COSTS(000):$0
Disclosure of Ownership and Financial Control Interest Statement
and Supporting Regulations Contained in 42 CFR 420.200-.206 and
455.100-.106
FORMS: CMS-1513
OMB NO: 0938-0155 EXPIRATION DATE: 12/31/2003
RESPS:14 HOURS:476 COSTS(000):$0
Municipal Health Services Cost Report Form and Supporting
Regulations 42 CFR 405.2470
FORMS: HCFA-255
OMB NO: 0938-0165 EXPIRATION DATE: 03/31/2006
RESPS:225 HOURS:7,860 COSTS(000):$0
Prepaid Health Plan Cost Report
FORMS: CMS-276
OMB NO: 0938-0170 EXPIRATION DATE: 09/30/2005
RESPS:1,363 HOURS:682 COSTS(000):$0
Blood Bank Inspection Checklist and Report and Supporting
Regulations in 42 CFR 493.1269-493-1285
FORMS: CMS-282
OMB NO: 0938-0193 EXPIRATION DATE: 05/31/2004
RESPS:56 HOURS:560 COSTS(000):$0
Transmittal and Notice of Approval of State Plan Material and
Supporting Regulations in 42 CFR 430.10-430.20 and 440.167
FORMS: HCFA-179
OMB NO: 0938-0202 EXPIRATION DATE: 06/30/2005
RESPS:1,231 HOURS:573,646 COSTS(000):$0
Home Office Cost Statement and Supporting Regulations in 42 CFR
413.17 and 413.20
FORMS: CMS-287-92
OMB NO: 0938-0214 EXPIRATION DATE: 05/31/2004
RESPS:867,863,540 HOURS:1,339,982 COSTS(000):$0
Medicare Secondary Payer Information Collection and Supporting
Regulations in 42 CFR 411.25, 489.2, and 489.20
FORMS: CMS-250-254
OMB NO: 0938-0242 EXPIRATION DATE: 07/31/2003
RESPS:27,900 HOURS:25,000 COSTS(000):$0
Fire Safety Survey Report Forms and supporting regulations in 42
CFR 416.44, 418.100, 482.41, 483.270, and 483.470
FORMS: CMS-2786-A-D 2786-F 2786-G 2786-H 2786-J 2786-K 2786-L 2786-M
2786-P 2786-Q
OMB NO: 0938-0245 EXPIRATION DATE: 04/30/2003
RESPS:10,000 HOURS:2,500 COSTS(000):$0
Request for Enrollment in Supplementary Medical Insurance and
Supporting Regulations in 42 CFR 407.10 & 407.11
FORMS: HCFA-4040
OMB NO: 0938-0251 EXPIRATION DATE: 09/30/2004
RESPS:50,000 HOURS:12,500 COSTS(000):$0
Application for Hospital Insurance in 42 CFR 406.7
FORMS: HCFA-18F5
OMB NO: 0938-0266 EXPIRATION DATE: 04/30/2003
RESPS:2,931 HOURS:1,434 COSTS(000):$0
Ambulatory Surgical Center Request for Certification and Survey
Report and Supporting Regulations in 42 CFR 416.1-416.150
FORMS: HCFA-377 HCFA-378 HCFA-R-54
OMB NO: 0938-0267 EXPIRATION DATE: 04/30/2003
RESPS:540 HOURS:260,848 COSTS(000):$0
Comprehensive Outpatient Rehabilitation Facility (CORF)
Eligibility and Survey Forms and Information Collection
Requirements at 42 CFR 485.56, 485.58, 485.60, 485.64....
FORMS: HCFA-359 360 R-55
OMB NO: 0938-0269 EXPIRATION DATE: 12/31/2005
RESPS:750 HOURS:375 COSTS(000):$0
Request for Accelerated Payments and Supporting Regulations in
42 CFR, section 412.116, 412.632, 413.64, 413.350, and 484.245
FORMS: CMS-9042
OMB NO: 0938-0270 EXPIRATION DATE: 09/30/2004
RESPS:500 HOURS:1,000 COSTS(000):$0
The Financial Statement of Debtor and Supporting Regulations in
42 CFR, Section 405.376
FORMS: HCFA-379
OMB NO: 0938-0272 EXPIRATION DATE: 10/31/2003
RESPS:243 HOURS:18,225 COSTS(000):$0
Annual Report on Home and Community-Based Services Waivers and
Supporting Regulations in 42 CFR 440.181 and 441.300-305, Forms
HCFA-372 and HCFA-372(S)
FORMS: HCFA-372 HCFA-372(S)
OMB NO: 0938-0273 EXPIRATION DATE: 10/31/2005
RESPS:2,833 HOURS:708 COSTS(000):$0
Identification of Extension Units of Outpatient Physical
Therapy/Outpatient Speech Pathology (OPT/OSP) Providers and
Supporting Regulations in 42 CFR Sections 485.701 - 485.729
FORMS: CMS-381
OMB NO: 0938-0279 EXPIRATION DATE: 04/30/2003
RESPS:158,603,290 HOURS:1,960,991 COSTS(000):$0
Medicare Uniform Institutional Provider Bill and Supporting
Regulatins in 42 CFR 424.5
FORMS: HCFA-1450
OMB NO: 0938-0287 EXPIRATION DATE: 12/31/2005
RESPS:27 HOURS:81 COSTS(000):$0
Withholding Medicare Payments to Recover Medicaid Overpayments
and Supporting Regulations in 42 CFR 447.31
FORMS: HCFA-R-0021
OMB NO: 0938-0296 EXPIRATION DATE: 04/30/2004
RESPS:291 HOURS:14,000 COSTS(000):$0
Provider Reimbursement Manual, Part 1-Chapter 27, Sections 2721,
2722 & 2725, Request for Exception to End Stage Renal Disease
Composite Rates & Supporting Regulations in 42 CFR 413.170......
FORMS: HCFA-9044
OMB NO: 0938-0300 EXPIRATION DATE: 10/31/2004
RESPS:51 HOURS:6,891 COSTS(000):$0
Quality Control of Negative Case Actions (NCA)
FORMS: CMS-6401
OMB NO: 0938-0313 EXPIRATION DATE: 08/31/2004
RESPS:2,286 HOURS:572 COSTS(000):$0
Hospice Request for Certification in the Medicare Program and
Supporting Regulations Contained in 42 CFR Part 418.1-418.405
FORMS: HCFA-417
OMB NO: 0938-0334 EXPIRATION DATE: 04/30/2003
RESPS:3,528 HOURS:9,744 COSTS(000):$0
Conditions of Participation for Rural Health Clinics and
Supporting Regulations in 42 CFR, Section 491.9, Subpart A
FORMS: HCFA-R-38
OMB NO: 0938-0338 EXPIRATION DATE: 09/30/2005
RESPS:645 HOURS:1,612 COSTS(000):$0
Conditions of Participation for Portable X-ray Supliers and
Supporting Regulations in 42 CFR Sections 486.104, 486.106, and
406.110
FORMS: CMS-R-43
OMB NO: 0938-0345 EXPIRATION DATE: 09/30/2005
RESPS:212 HOURS:2,120 COSTS(000):$45
Medicaid Statistical Information System
FORMS: CMS-R-0284
OMB NO: 0938-0354 EXPIRATION DATE: 11/30/2005
RESPS:56 HOURS:1,568 COSTS(000):$15
Annual Early and Periodic Screening, Diagnostic and Treatment
Services (EPSDT) Participation Report
FORMS: CMS-416
OMB NO: 0938-0355 EXPIRATION DATE: 09/30/2003
RESPS:13,994 HOURS:19,884 COSTS(000):$0
Home Health Agency survey and Deficiencies Report, Home Health
Functional Assessment Instrument and Supporting Regulations in
42 CFR Part 484.10 - 42 CFR Part 484.52
FORMS: HCFA-1572 HCFA-1515
OMB NO: 0938-0357 EXPIRATION DATE: 11/30/2005
RESPS:4,750,000 HOURS:1,583,333 COSTS(000):$0
Home Health Services Under Hospital Insurance, Manual
Instructions and Supporting Regulations in 42 CFR 409.40 - 50,
410.36, 410.170, 411.4-.15, 421.100, 424.22, 484.18 and 489.21
FORMS: CMS-485
OMB NO: 0938-0358 EXPIRATION DATE: 12/31/2003
RESPS:2,580 HOURS:645 COSTS(000):$0
Psychiatric Unit Criteria Work Sheet, Rehabilitation Unit
Criteria Work Sheet and Rehabilitation Hospital Criteria Work
Sheet, and Supporting Regulations at 42 CFR 412.20 - 412.30
FORMS: HCFA-437 437A 437B
OMB NO: 0938-0359 EXPIRATION DATE: 03/31/2005
RESPS:899,340 HOURS:26,982 COSTS(000):$0
Medical Records Review Under PPS and Supporting Regulations at
42 CFR 412.40-412.52
FORMS: CMS-R-50
OMB NO: 0938-0360 EXPIRATION DATE: 11/30/2003
RESPS:675 HOURS:1,626 COSTS(000):$0
End Stage Renal Disease Application and Survey and Certification
Report Form and Supporting Regulations 42 CFR 405.2100 - 405.2184
FORMS: HCFA-3427
OMB NO: 0938-0365 EXPIRATION DATE: 05/31/2004
RESPS:7,500 HOURS:862,585 COSTS(000):$0
Home Health Medicare Conditions of Participation (CoP)
Information Collection Requirements as Outlined in Regulation --
42 CFR 484
FORMS: HCFA-R-39
OMB NO: 0938-0378 EXPIRATION DATE: 08/31/2004
RESPS:250 HOURS:125 COSTS(000):$0
The Medicare/Medicaid Psychiatric Hospital Survey Data Contained
in 42 CFR and Supporting Regultions in 42 CFR 482.60, 482.61,
and 482.62
FORMS: HCFA-724
OMB NO: 0938-0379 EXPIRATION DATE: 08/31/2003
RESPS:2,293 HOURS:5,733 COSTS(000):$0
Hospice Survey and Deficiencies Report Form and Supporting
Regulations at 42 CFr Part 418.1 - 418.405
FORMS: 643
OMB NO: 0938-0380 EXPIRATION DATE: 08/31/2003
RESPS:2,000 HOURS:500 COSTS(000):$0
Hospital Request for Certification in the Medicare/Medicaid
Program
FORMS: HCFA-1514
OMB NO: 0938-0386 EXPIRATION DATE: 04/30/2003
RESPS:3,940 HOURS:143,721 COSTS(000):$0
Conditions for Coverage of Suppliers of End Stage Renal Disease
(ESRD) Services and Supporting Regulations Contained in 42 CFR
405.2100-.2171
FORMS: HCFA-R-52
OMB NO: 0938-0391 EXPIRATION DATE: 02/28/2006
RESPS:60,000 HOURS:120,000 COSTS(000):$0
Statement of Deficiencies and Plan of Correction and Supporting
Regulations Contained in 42 CFR 488.18, 488.26, and 488.28
FORMS: CMS-2567
OMB NO: 0938-0408 EXPIRATION DATE: 07/31/2003
RESPS:25 HOURS:2,000 COSTS(000):$0
Methodology for Estimating Waiver Costs of HCFA Demonstration
Projects
FORMS: HCFA-482
OMB NO: 0938-0426 EXPIRATION DATE: 02/28/2006
RESPS:3,729 HOURS:60,919 COSTS(000):$0
Information Collection Requirements in HSQ-110, Acquisition,
Protection and Disclosure of Peer Review Organization
Information and Supporting Regulations in 42 CFR, Section
480.104, 480.105,..
FORMS: CMS-R-70
OMB NO: 0938-0429 EXPIRATION DATE: 05/31/2004
RESPS:2 HOURS:20 COSTS(000):$0
Imposition of Cost Sharing Charges Under Medicaid and Supporting
Regulations contained in 42 CFR Section 447.53
FORMS: HCFA-R-0053
OMB NO: 0938-0443 EXPIRATION DATE: 04/30/2003
RESPS:15,670 HOURS:3,578 COSTS(000):$0
Information Collection Requirements in 42 CFR 473.18, 473.34,
473.36, and 473.42, PRO Reconsideration and Appeals
FORMS: HCFA-R-72
OMB NO: 0938-0444 EXPIRATION DATE: 10/31/2005
RESPS:1,060 HOURS:22,684 COSTS(000):$0
Information Collection Requirements in Final Peer Review
Organizations Sanction Regulations -- 42 CFR Sections 1004.40,
1004.50, 1004.60, and 1004.70
FORMS: HCFA-R-65
OMB NO: 0938-0445 EXPIRATION DATE: 08/31/2005
RESPS:6,036 HOURS:81,818 COSTS(000):$0
Information Collection Requirements in HSQ-108F Assumption of
Responsibilities and Supporting Regulations in 42 CFR Sections
412.44, 412.46, 431.630, 456.654, 476.71, 476.73, 476.74, 476.78
FORMS: HCFA-R-71
OMB NO: 0938-0447 EXPIRATION DATE: 04/30/2003
RESPS:3,761 HOURS:30,088 COSTS(000):$0
End Stage Renal Disease Medical Information System ESRD Facility
Survey
FORMS: HCFA-2744
OMB NO: 0938-0448 EXPIRATION DATE: 03/31/2006
RESPS:63,000 HOURS:10,710 COSTS(000):$0
End Stage Renal Disease Death Notification P. L. 95-292;
42CFR405.2133; CFR401,422E
FORMS: CMS-2746
OMB NO: 0938-0449 EXPIRATION DATE: 07/31/2005
RESPS:132 HOURS:7,930 COSTS(000):$0
Home and Community-Based Waiver Requests and Supporting
Regulations; 42 CFR 440.180, 441.300-.310
FORMS: CMS-8003
OMB NO: 0938-0463 EXPIRATION DATE: 05/31/2004
RESPS:15,700 HOURS:2,943,354 COSTS(000):$0
Skilled Nursing Facility and Skilled Nursing Facility Cost
Report and Supporting Regulations in 42 CFR 413.20, 413.24, and
413.106
FORMS: HCFA-2540-96
OMB NO: 0938-0465 EXPIRATION DATE: 11/30/2003
RESPS:3,563,304 HOURS:296,942 COSTS(000):$0
Limitation on Liability and Information Collection Requirements
Referenced in 42 CFR 411.404, 411.406, and 411.408
FORMS: HCFA-R-77
OMB NO: 0938-0467 EXPIRATION DATE: 10/31/2005
RESPS:54 HOURS:99,254 COSTS(000):$0
Income and Eligibility Verification System Reporting and
Supporting Regulations
FORMS: R-0074
OMB NO: 0938-0470 EXPIRATION DATE: 11/30/2003
RESPS:35 HOURS:3,500 COSTS(000):$471
Qualification Application and Supporting Regulations in 42 CFR,
Section 417.408 and 417.143
FORMS: HCFA-901-1
OMB NO: 0938-0477 EXPIRATION DATE: 07/31/2005
RESPS:40 HOURS:160 COSTS(000):$0
Payment Adjustment for Sole Community Hospitals and Supporting
Regulations in 42 CFR Section 412.92
FORMS: CMS-R-79
OMB NO: 0938-0484 EXPIRATION DATE: 04/30/2003
RESPS:1,100 HOURS:275 COSTS(000):$0
Emergency and Foreign Hospital Services -- Beneficiary Statement
in Canadian Travel Claims and Supporting Regulations in 42 CFR,
Section 424.123
FORMS: HCFA-R-96
OMB NO: 0938-0486 EXPIRATION DATE: 10/31/2003
RESPS:10,000 HOURS:2,500 COSTS(000):$0
Regulations for Hearing for Part A Medicare by an Administrative
Law Judge and Supporting Regulations in 42 CFR, 498 Subpart D
and E
FORMS: HCFA-5011A-U6
OMB NO: 0938-0490 EXPIRATION DATE: 10/31/2005
RESPS:4 HOURS:400 COSTS(000):$0
Criteria for Medicare Coverage of Heart Transplants
FORMS: CMS-R-106
OMB NO: 0938-0501 EXPIRATION DATE: 04/30/2004
RESPS:4,300 HOURS:731 COSTS(000):$0
Medicare Qualification Statement for Federal Employees and
Supporting Regulations in 42 CFR 406.15
FORMS: HCFA-565
OMB NO: 0938-0502 EXPIRATION DATE: 01/31/2006
RESPS:1,900,000 HOURS:329,965 COSTS(000):$0
Medicaid - Determining Third Party Liability (TPL) State Plan
Preprint and Supporting Regulations in 42 CFR 433.138
FORMS: CMS-R-107
OMB NO: 0938-0507 EXPIRATION DATE: 06/30/2003
RESPS:85,000 HOURS:2,805 COSTS(000):$0
Medicare Managed Care Disenrollment Form
FORMS: HCFA-566
OMB NO: 0938-0512 EXPIRATION DATE: 11/30/2003
RESPS:69 HOURS:138 COSTS(000):$0
Organ Procurement Organization's Request for Designation and
Supporting Regulations in 42 CFR 486.301 - 486.325
FORMS: CMS-576
OMB NO: 0938-0526 EXPIRATION DATE: 08/31/2004
RESPS:53 HOURS:1 COSTS(000):$0
Peer Review Organization Contracts: Solicitation of Statements
of Interest from In-State Organizations, General Notice--CFR 475
FORMS: HCFA-R-118
OMB NO: 0938-0534 EXPIRATION DATE: 05/31/2003
RESPS:500,000 HOURS:50,000 COSTS(000):$0
Attending Physician's Certification of Medical Necessity for
Home Oxygen Therapy and Supporting Regulations 42 CFR 410.38 and
42 CFR 424.5
FORMS: CMS-484
OMB NO: 0938-0544 EXPIRATION DATE: 02/28/2006
RESPS:13,250 HOURS:6,625 COSTS(000):$0
Survey Report Form Clinical Laboratory Improvement Amendments
(CLIA) and Supporting Regulations in 42 CFR 493.1-493.2001
FORMS: HCFA-1557
OMB NO: 0938-0565 EXPIRATION DATE: 11/30/2005
RESPS:327,947 HOURS:1,096,466 COSTS(000):$0
Internal Revenue Service/Social Security Administration/Centers
for Medicare & Medicaid Services Data Match and Supporting
Regulations in 42 CFR Sections 411.20-411.206
FORMS: CMS-R-137
OMB NO: 0938-0566 EXPIRATION DATE: 06/30/2003
RESPS:19,660,110 HOURS:1,638,345 COSTS(000):$122,700
Advance Beneficiary Notice and Supporting Regulations in 42 CFR
411.404, 411.406, and 411.408
FORMS: CMS-R-131
OMB NO: 0938-0567 EXPIRATION DATE: 10/31/2003
RESPS:1,000 HOURS:2,500 COSTS(000):$0
Request for Hearing for Part B Medicare by an Administrative Law
Judge and Supporting Regulations in 42 CFR, 498 Subpart D and E
FORMS: HCFA-5011B-U6
OMB NO: 0938-0573 EXPIRATION DATE: 10/31/2005
RESPS:650 HOURS:650 COSTS(000):$0
Medicare Geographic Classification Review Board (MGCRB)
Procedures and Criteria and Supporting Regulations in 42 CFR,
Section 412.256 and 412.230
FORMS: CMS-R-0138
OMB NO: 0938-0575 EXPIRATION DATE: 07/31/2003
RESPS:50 HOURS:150 COSTS(000):$0
Analysis of Malpractice Premium Data
FORMS: HCFA-R-143
OMB NO: 0938-0578 EXPIRATION DATE: 07/31/2003
RESPS:2,204 HOURS:54,660 COSTS(000):$948
Medicaid Drug Rebate Program - Manufacturers
FORMS: HCFA-367 HCFA-367A HCFA-367B HCFA-367C
OMB NO: 0938-0579 EXPIRATION DATE: 04/30/2003
RESPS:20 HOURS:535 COSTS(000):$0
Business Proposal Formats for Utilization and Quality Control
Peer Review Organizations (PROs)
FORMS: 718-BP 719-BP 720-BP 721-BP SUM-PS IS CA SS SC-1 SC-2
OMB NO: 0938-0580 EXPIRATION DATE: 04/30/2004
RESPS:12 HOURS:2,110 COSTS(000):$0
Criteria for Medicare Coverage of Liver Transplants
FORMS: HCFA-R-108
OMB NO: 0938-0600 EXPIRATION DATE: 10/31/2005
RESPS:186,800 HOURS:1,120,800 COSTS(000):$0
Medicare Credit Balance Reporting Requirements and Supporting
Regulations in 42 CFR 405.371, 405.378, and 413.20
FORMS: CMS-838
OMB NO: 0938-0610 EXPIRATION DATE: 07/31/2005
RESPS:34,365 HOURS:960,500 COSTS(000):$0
Information Collection Requirements Contained in BDP-718:
Advanced Directives (Medicare and Medicaid) and Supporting
Regulations in 42 CFR Sections 417.436, 417.801, 422.128,....
FORMS: HCFA-R-10
OMB NO: 0938-0612 EXPIRATION DATE: 06/30/2004
RESPS:700,650 HOURS:10,230,714 COSTS(000):$0
Clinical Laboratory Improvement Amendments (CLIA) and the ICRs
contained in the supporting regulations in 42 CFR 493.1-.2001
FORMS: HCFA-R-26
OMB NO: 0938-0618 EXPIRATION DATE: 01/31/2005
RESPS:40 HOURS:2,880 COSTS(000):$0
Limitations on Provider Related Donations and Health Care
Related Taxes; Limitation on payments to Disproportionate Share
Hospitals; Medicaid and Supporting Regulations in 42 CFR 433.68,.
FORMS: HCFA-R-148
OMB NO: 0938-0624 EXPIRATION DATE: 04/30/2003
RESPS:50 HOURS:12 COSTS(000):$0
Hospital Provider of Extended Care Services (Swing-Beds) in the
Medicare and Medicaid Programs, 42 CFR 447.280 and 482.66
FORMS: HCFA-605
OMB NO: 0938-0626 EXPIRATION DATE: 04/30/2003
RESPS:10,000 HOURS:1,250 COSTS(000):$0
Authorization Agreement for Electronic Funds Transfer
FORMS: HCFAA-588
OMB NO: 0938-0657 EXPIRATION DATE: 12/31/2003
RESPS:36 HOURS:108 COSTS(000):$0
End-Stage Renal Disease (ESRD) Network Semi-Annual Cost Report
Forms and Supporting Regulations in 42 CFR 405.2110 and 42 CFR
405.2112
FORMS: HCFA-685
OMB NO: 0938-0658 EXPIRATION DATE: 12/31/2003
RESPS:36 HOURS:1,080 COSTS(000):$0
End-Stage Renal Disease (ESRD) Network Business Proposal Forms
and Supporting Regulations in 432 CFR 405.2110 and 42 CFR
405.2112
FORMS: HCFA-684A-684I
OMB NO: 0938-0667 EXPIRATION DATE: 11/30/2005
RESPS:5,600 HOURS:1 COSTS(000):$0
ICRs Contained in BPD-393, Examination and Treatment for
Emergency Medical Conditions and Women in Labor, 42 CFR 482.12,
488.18, 489.20, and 489.24, and HCFA-1005-IFC,....
FORMS: CMS-R-142
OMB NO: 0938-0670 EXPIRATION DATE: 05/31/2004
RESPS:6 HOURS:1,010 COSTS(000):$0
Criteria for Medicare Coverage of Lung Transplants
FORMS: HCFA-R-170
OMB NO: 0938-0676 EXPIRATION DATE: 05/31/2004
RESPS:3,744 HOURS:139,560 COSTS(000):$350
Reconciliation of State Invoice and Prior Quarter Adjustment
Statement (Medicaid Drug Rebate Program - Labelers)
FORMS: HCFA-304 HCFA-304A
OMB NO: 0938-0679 EXPIRATION DATE: 04/30/2003
RESPS:6,700,000 HOURS:1,130,000 COSTS(000):$0
Durable Medical Equipment Regional Carrier, Certificate of
Medical Necessity
FORMS: CMS-841 CMS-842 CMS-844 CMS-853
OMB NO: 0938-0685 EXPIRATION DATE: 04/30/2003
RESPS:274,000 HOURS:642,000 COSTS(000):$0
Medicare Federal Health Care Provider/Supplier Enrollment
Application
FORMS: HCFA-855A HCFA-855B HCFA-855I HCFA-855R HCFA-855S
OMB NO: 0938-0686 EXPIRATION DATE: 03/31/2005
RESPS:76 HOURS:768 COSTS(000):$0
Granting and Withdrawal of Deeming Authority to Private
Nonprofit Accrediation Organizations and of State Exemption
Under State Laboratory Programs & Supporting Regulation in 42
CFR 493.551-...
FORMS: HCFA-R-185
OMB NO: 0938-0690 EXPIRATION DATE: 10/31/2005
RESPS:28 HOURS:451 COSTS(000):$0
Granting and Withdrawal of Deeming Authority to National
Accreditation Organizations and Supporting Regulations at 42 CFR
488.4-488.9, and 488.201
FORMS: CMS-R-191
OMB NO: 0938-0691 EXPIRATION DATE: 10/31/2005
RESPS:100 HOURS:100 COSTS(000):$0
Medicare Disproportionate Share Adjustment Procedures and
Criteria and Supporting Regulations in 42 CFR 412.106
FORMS: CMS-R-194
OMB NO: 0938-0692 EXPIRATION DATE: 01/31/2006
RESPS:11,800,000 HOURS:196,666 COSTS(000):$0
"Important Message from Medicare" Title XVII Section 1866(a)(1)
(M), 42 CFR Section 466.78, 489.20, and 489.27
FORMS: CMS-R-193
OMB NO: 0938-0697 EXPIRATION DATE: 12/31/2003
RESPS:57 HOURS:342 COSTS(000):$0
Medicaid Report on Payables and Receivables
FORMS: HCFA-R-199
OMB NO: 0938-0701 EXPIRATION DATE: 09/30/2003
RESPS:313,825 HOURS:186,320 COSTS(000):$0
Health Plan Employer Data and Information Set (HEDIS ) and
Health Outcome Survey (HOS) and Supporting Regulations at CFR
422.152
FORMS: CMS-R-200
OMB NO: 0938-0702 EXPIRATION DATE: 04/30/2003
RESPS:43,000,000 HOURS:2,700,000 COSTS(000):$0
Information Collection Requirements Referenced in HIPAA for the
Group Market -- Supporting Regulations 45 CFR 146 and
Forms/Instructions
FORMS: HCFA-R-206
OMB NO: 0938-0703 EXPIRATION DATE: 04/30/2003
RESPS:3,230,000 HOURS:923,000 COSTS(000):$0
Information Collection Requirements Referenced in HIPAA for the
Form/Instructions
FORMS: HCFA-R-205
OMB NO: 0938-0705 EXPIRATION DATE: 10/31/2003
RESPS:92,803 HOURS:415 COSTS(000):$0
"Maximizing the Effective Use of Telemedicine: A Study of the
Effects, Cost Effectiveness and Utilization Patterns of
Consultations via Telemedicine"
FORMS: HCFA-R-197
OMB NO: 0938-0707 EXPIRATION DATE: 05/31/2005
RESPS:42 HOURS:6,720 COSTS(000):$0
Model Application Template for State Child Health Plan Under
Title XXI of the Social Security Act, State Children's Health
Insurance Program, & Model Application Template and Instructions
FORMS: HCFA-R-211
OMB NO: 0938-0708 EXPIRATION DATE: 04/30/2004
RESPS:1,200 HOURS:744 COSTS(000):$0
Evaluation of the State Medicaid Reform Demonstrations and
Evaluation of the Medicaid Health Reform Demonstrations
FORMS: HCFA-R-207
OMB NO: 0938-0709 EXPIRATION DATE: 03/31/2004
RESPS:69,717 HOURS:32,917 COSTS(000):$0
Data Collection for the Second Generation Social Health
Maintenance Organization Demonstration
FORMS: HCFA-R-204
OMB NO: 0938-0714 EXPIRATION DATE: 10/31/2004
RESPS:200 HOURS:2,000 COSTS(000):$0
Procedures for Advisory Opinions Concerning Physician Referrals
and Supporting Regulations in 42 CFR Sections 411.370 through
411.389
FORMS: HCFA-R-216
OMB NO: 0938-0722 EXPIRATION DATE: 09/30/2004
RESPS:10 HOURS:100 COSTS(000):$0
Medicare+Choice Provider Sponsored Organization Waiver Request
Form and Supporting Regulations at 42 CFR 422.370 through 422.378
FORMS: HCFA-R-231
OMB NO: 0938-0723 EXPIRATION DATE: 10/31/2005
RESPS:5 HOURS:1,000 COSTS(000):$0
Medicare Integrity Program Organizational Conflict of Interest
Disclosure Certificate and Supporting Regultions at 42 CFR
421.300 - 421.318
FORMS: HCFA-R-232
OMB NO: 0938-0730 EXPIRATION DATE: 08/31/2004
RESPS:26,280 HOURS:7,197 COSTS(000):$0
Subpart D-Private Contracts and Supporting Regulations in 42 CFR
405.410, 405.430, 405.435, 405.440, 405.445, 405.455, 410.61,
415.110, and 424.24
FORMS: R-234
OMB NO: 0938-0731 EXPIRATION DATE: 04/30/2005
RESPS:448 HOURS:7,840 COSTS(000):$0
Quarterly Children's Health Insurance Program Statement of
Expenditures for Title XXI
FORMS: HCFA-21 HCFA-21B
OMB NO: 0938-0732 EXPIRATION DATE: 05/31/2004
RESPS:168,000 HOURS:55,450 COSTS(000):$0
The Medicare Managed Care CAHPS Survey and Supporting
Regulations in 42 CFR 417.126 and 417.470
FORMS: HCFA-R-246
OMB NO: 0938-0734 EXPIRATION DATE: 09/30/2004
RESPS:1,500 HOURS:750 COSTS(000):$0
Data Use Agreement Information Collection Requirements, model
language, and supporting regulations in 42 CFR Section 5b
FORMS: HCFA-R-235
OMB NO: 0938-0738 EXPIRATION DATE: 11/30/2005
RESPS:2,400 HOURS:600 COSTS(000):$0
National Medicare Education Program (NMEP) Community Survey of
Medicare Beneficiaries
FORMS: CMS-R-254
OMB NO: 0938-0739 EXPIRATION DATE: 03/31/2006
RESPS:2,657,859 HOURS:2,640,371 COSTS(000):$0
SNF Resident Assessment MDS Data and Supporting Regulations in
42 CFR 413,337, 413.343, 424.32, and 483.20
FORMS: CMS-R-250
OMB NO: 0938-0741 EXPIRATION DATE: 12/31/2005
RESPS:50,000 HOURS:3,300 COSTS(000):$0
Medicare+Choice Disenrollment Form to Original Medicare and
Supporting Regulations 422.66
FORMS: CMS-R-257
OMB NO: 0938-0758 EXPIRATION DATE: 03/31/2005
RESPS:1,720 HOURS:302,720 COSTS(000):$0
Hospice Cost Report and Supporting Regulations in 42 CFR 413.20
and 413.24
FORMS: CMS-R-249
OMB NO: 0938-0760 EXPIRATION DATE: 07/31/2003
RESPS:9,510,900 HOURS:8,013,013 COSTS(000):$0
Medicare and Medicaid Programs Use of the OASIS as Part of the
CoPs for HHAs and Supporting Regulations in Part 484 of 42 CFR
FORMS: CMS-R-245
OMB NO: 0938-0761 EXPIRATION DATE: 07/31/2003
RESPS:85,200 HOURS:838,408 COSTS(000):$17,800
Medicare and Medicaid Programs: Use and Reporting OASIS Data as
Part of the CoPs for HHAs and Supporting Regulations in 42 CFR
484.11 and 484.20
FORMS: CMS-R-209
OMB NO: 0938-0763 EXPIRATION DATE: 04/30/2003
RESPS:300 HOURS:900 COSTS(000):$0
The Adjusted Community Rate Proposal (ACRP) M+C Plan Benefit
Package & Supporting Regulations in 42 CFR 417.401,
422.1-422.10,
422.50-422.80,422.100-422.132,422.300-422.312,422.400-422.404....
FORMS: HCFA-R-262
OMB NO: 0938-0770 EXPIRATION DATE: 12/31/2005
RESPS:4,550 HOURS:17,400 COSTS(000):$0
Site Visit Assessment Tool (previously known as Community Mental
Health Center Site Visit Assessment Tool) and Supporting
Regulations in 432 CFR 410.2
FORMS: CMS-R-273
OMB NO: 0938-0776 EXPIRATION DATE: 09/30/2004
RESPS:200 HOURS:8,000 COSTS(000):$0
Medicare Program: Procedures for Making National Coverage
Decisions
FORMS: CMS-R-0290
OMB NO: 0938-0781 EXPIRATION DATE: 06/30/2005
RESPS:145,966 HOURS:14,597 COSTS(000):$0
Information Collection Requirements and Supporting Regulations
in 42 CFR, Section 484.10(a)
FORMS: CMS-R-296
OMB NO: 0938-0786 EXPIRATION DATE: 04/30/2003
RESPS:11,609 HOURS:135,110 COSTS(000):$0
External Quality Review of Medicaid MCOs and Supporting
Regulations in 42 CFR 438.360, 438.362, and 438.364
FORMS: HCFA-R-0305
OMB NO: 0938-0787 EXPIRATION DATE: 08/31/2004
RESPS:5,000 HOURS:750 COSTS(000):$0
Request for Employment Information
FORMS: HCFA-R-297
OMB NO: 0938-0790 EXPIRATION DATE: 01/31/2006
RESPS:54 HOURS:44,078 COSTS(000):$0
Medicare and Medicaid: Programs of All-inclusive Care for the
Elderly (PACE) Contained in 42 CFR 460.12-460.210/Medicare and
Medicaid: Program of All-inclusive Care for the Elderly (PACE);..
FORMS: CMS-R-244
OMB NO: 0938-0791 EXPIRATION DATE: 03/31/2004
RESPS:90,070 HOURS:22,503 COSTS(000):$0
A Project to Develop an Outcome-Based Continuous Quality
Improvement System and Core Outcome and Comprehensive Assessment
Data Set for PACE
FORMS: CMS-R-299
OMB NO: 0938-0792 EXPIRATION DATE: 04/30/2003
RESPS:3,573 HOURS:3,663 COSTS(000):$0
Rural Health Clinics: Amendments to Participation Requirements &
Payment Provisions; & Establishments of a Quality Assessment &
Performance Improvement Program & Supporting Regulations.....
FORMS: HCFA-R-0242
OMB NO: 0938-0795 EXPIRATION DATE: 08/31/2004
RESPS:37 HOURS:11,100 COSTS(000):$0
Conflict of Interest and Ownership and Control Information
FORMS: HCFA-R-312
OMB NO: 0938-0796 EXPIRATION DATE: 05/31/2004
RESPS:134,400 HOURS:44,800 COSTS(000):$0
Medicare Consumer Assessment of Health Plan Survey - Fee for
Service (CAHPS-FFS)
FORMS: HCFA-10000
OMB NO: 0938-0798 EXPIRATION DATE: 08/31/2003
RESPS:2,752 HOURS:41,063 COSTS(000):$0
Prospective Payments for Hospital Outpatient Services and
Supporting Regulations in 42 CFR 143.65, and 419.42
FORMS: HCFA-R-240
OMB NO: 0938-0799 EXPIRATION DATE: 09/30/2003
RESPS:56 HOURS:5,600 COSTS(000):$0
TWWIA Demonstration to Maintain Independence and Employment
FORMS: HCFA-10006
OMB NO: 0938-0801 EXPIRATION DATE: 08/31/2003
RESPS:51 HOURS:102 COSTS(000):$0
Evaluation of QMB and SLMB Outreach Activities
FORMS: HCFA-R-317
OMB NO: 0938-0802 EXPIRATION DATE: 05/31/2005
RESPS:55 HOURS:193 COSTS(000):$0
Recognition of pass-through payment for drugs and biologicals
under the Outpatient Prospective Payment System and Supporting
Regulations in 42 CFR, Section 419.43, formerly known as......
FORMS: CMS-10008
OMB NO: 0938-0808 EXPIRATION DATE: 10/31/2003
RESPS:2,174 HOURS:4,735 COSTS(000):$0
Study to Support Development and Refinement of a Classification
System and Prospective Payment System for Patients in Inpatient
Rehabilitation Hospitals and Exempt Rehabilitation Units
FORMS: HCFA-R-311
OMB NO: 0938-0810 EXPIRATION DATE: 11/30/2003
RESPS:1,491,700 HOURS:146,070 COSTS(000):$0
Hospital Condition of Participation; Identification of Potential
Organ, Tissue, & Eye Donors & Transplant Hospitals' Provision of
Transplant-Related Data & Supporting Regulation at 42 CFR 482.45
FORMS: HCFA-R-0294
OMB NO: 0938-0811 EXPIRATION DATE: 11/30/2003
RESPS:56 HOURS:5,600 COSTS(000):$0
Ticket to Work and Work Incentives: Medicaid Infrastructure
Grants
FORMS: HCFA-10005
OMB NO: 0938-0812 EXPIRATION DATE: 11/30/2003
RESPS:150 HOURS:37 COSTS(000):$0
Employee Building Pass Application and File
FORMS: HCFA-730 HCFA-182
OMB NO: 0938-0813 EXPIRATION DATE: 12/31/2003
RESPS:1,500 HOURS:500 COSTS(000):$0
Evaluation of the OMB and SLMB Programs -- Beneficiary Survey
FORMS: HCFA-10015
OMB NO: 0938-0817 EXPIRATION DATE: 11/30/2003
RESPS:3,600 HOURS:684 COSTS(000):$0
Survey of Medicare Beneficiaries Who Involuntarily Disenroll
From Their Health Plan
FORMS: CMS-10026
OMB NO: 0938-0820 EXPIRATION DATE: 05/31/2003
RESPS:500 HOURS:542 COSTS(000):$0
Follow-Up of Medicare+Choice Disenrollees Receiving
Fee-for-Service Inpatient Hospital Care
FORMS: HCFA-10017
OMB NO: 0938-0823 EXPIRATION DATE: 04/30/2004
RESPS:150 HOURS:50 COSTS(000):$0
Suggestion Program on Methods to Improve Medicare Efficiency and
Supporting Regulations in 42 CFR 420.410
FORMS: HCFA-R-0255
OMB NO: 0938-0824 EXPIRATION DATE: 05/31/2004
RESPS:75 HOURS:3 COSTS(000):$0
Restraints/Seclusion Death Reporting for Hospitals and
Supporting Regulations at 42 CFR 482.13
FORMS: HCFA-10004
OMB NO: 0938-0826 EXPIRATION DATE: 06/30/2004
RESPS:4,800 HOURS:3,200 COSTS(000):$0
Survey of Medicaid Home and Community-Based Services Waiver and
Personal Care Option Recipients for the Multi-Site Study of
Medicaid HOme and Community-Based Services
FORMS: HCFA-10018
OMB NO: 0938-0829 EXPIRATION DATE: 05/31/2004
RESPS:29,892 HOURS:2,994 COSTS(000):$0
Medicare+Choice Beneficiary Appeal Notices, "Notice of Denial of
Medical Services", "Notice of Denial of Request for Payment" and
Supporting Regulations in 42 CFR 422.568
FORMS: HCFA-10003
OMB NO: 0938-0832 EXPIRATION DATE: 07/31/2004
RESPS:3,000 HOURS:150 COSTS(000):$0
Health Insurance Benefit Agreement and Supporting Regulations at
42 CFR Part 489
FORMS: HCFA-1561
OMB NO: 0938-0833 EXPIRATION DATE: 03/31/2005
RESPS:2,600,000 HOURS:877,750 COSTS(000):$0
Restraint and Seclusion Standards for Psychiatric Residential
Treatment Facilities
FORMS: CMM-R-306
OMB NO: 0938-0836 EXPIRATION DATE: 02/28/2005
RESPS:108 HOURS:540 COSTS(000):$0
Real Choice Systems Change Grants; Nursing Facility Transition/
Access Housing Grants; Community Personal Assistance Service and
Supports Grants, National Technical Assistance and Learning.....
FORMS: CMS-10037
OMB NO: 0938-0840 EXPIRATION DATE: 09/30/2003
RESPS:125 HOURS:11 COSTS(000):$0
Collection of Data on Quality Indicators for Congestive Heart
Failure Submitted by Medicare+Choice Organizations Requesting
Extra Payments in CY2002 and CY2003 and Supporting Regulations...
FORMS: HCFA-10035
OMB NO: 0938-0841 EXPIRATION DATE: 06/30/2004
RESPS:3,748,463 HOURS:720,999 COSTS(000):$0
State Children's Health Insurance Program and Supporting
Regulations in 42 CFR.
FORMS: HCFA-0308
OMB NO: 0938-0842 EXPIRATION DATE: 07/31/2005
RESPS:359,000 HOURS:269,250 COSTS(000):$0
Inpatient Rehabilitation Assessment Instrument and Data Set for
PPS for Inpatient Rehabilitation Facilities and Supporting
Regulations in 42 CFR, Parts 412 and 413
FORMS: CMS-10036
OMB NO: 0938-0846 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Physicians' Referral to Health Care Entities With Which They
Have Financial Relationships and Supporting Regulations in 42
CFR, Sections 411.1, 411.350 through 411.357 and 424.22
FORMS: CMS-10047
OMB NO: 0938-0847 EXPIRATION DATE: 04/30/2003
RESPS:3,900 HOURS:800 COSTS(000):$0
Long Term Care Awareness Project
FORMS: CMS-10041
OMB NO: 0938-0848 EXPIRATION DATE: 05/31/2005
RESPS:10 HOURS:80 COSTS(000):$0
Health Insurance Flexibility and Accountability Section 1115
Model Waiver
FORMS: 10048
OMB NO: 0938-0850 EXPIRATION DATE: 12/31/2003
RESPS:265 HOURS:159 COSTS(000):$0
State Health Insurance Assistance Program (SHIP) Client Report
FORMS: HCFA-10028A-C
OMB NO: 0938-0851 EXPIRATION DATE: 10/31/2005
RESPS:10,800 HOURS:2,700 COSTS(000):$0
Assessing the CMS Fall Campaigns
FORMS: CMS-10049
OMB NO: 0938-0857 EXPIRATION DATE: 01/31/2005
RESPS:100 HOURS:1,600 COSTS(000):$0
Recognition of pass-through payment for additional (new)
categories of devices under the Outpatient Prospective Payment
System and Supporting Regulations in 42 CFR, Part 419
FORMS: CMS-10052
OMB NO: 0938-0860 EXPIRATION DATE: 03/31/2005
RESPS:25 HOURS:250 COSTS(000):$0
Recognition of payment for new technology services for
Ambulatory Payment Classification (APCs) under the Outpatient
Prospective Payment System and Supporting Regulation in.......
FORMS: CMS-10054
OMB NO: 0938-0863 EXPIRATION DATE: 02/28/2005
RESPS:5,680 HOURS:1,914 COSTS(000):$0
Evaluation of the BadgerCare Medicaid Demonstration
FORMS: HCFA-10043
OMB NO: 0938-0866 EXPIRATION DATE: 05/31/2005
RESPS:3,400,000 HOURS:34,000,000 COSTS(000):$0
ICRs Contained in 45 CFR Part 162; HIPAA Standards for
Electronic Transactions
FORMS: CMS-R-0218
OMB NO: 0938-0867 EXPIRATION DATE: 07/31/2003
RESPS:6,322 HOURS:1,581 COSTS(000):$0
Survey of Medicare Private Fee-for-service (PFFS) Enrollees and
Nonenrollees
FORMS: CMS-10059
OMB NO: 0938-0872 EXPIRATION DATE: 12/31/2005
RESPS:156,480 HOURS:132,360 COSTS(000):$6,395
Minimum Data Set (MDS) for Swing Bed Hospitals and Supporting
Regulations in 42 CFR 483.20 and 413.337
FORMS: CMS-10064
OMB NO: 0938-0874 EXPIRATION DATE: 09/30/2005
RESPS:2,550,000 HOURS:1,700,000 COSTS(000):$51,000
HIPAA Standard Unique Employer Identifier and Supporting
Regulations in 45 CFR Part 160 and 162
FORMS: CMS-R-220
OMB NO: 0938-0875 EXPIRATION DATE: 04/30/2003
RESPS:129,000 HOURS:32,250 COSTS(000):$0
Durable Medical Equipment Regional Carrier, Certificate of
Medical Necessity
FORMS: CMS-843
OMB NO: 0938-0876 EXPIRATION DATE: 09/30/2005
RESPS:2,084 HOURS:348 COSTS(000):$0
Evaluation of the MassHealth Insurance Partnership
FORMS: CMS-10051
OMB NO: 0938-0877 EXPIRATION DATE: 07/31/2005
RESPS:11,356 HOURS:5,465 COSTS(000):$0
Evaluation of Programs of Coordinated Care and Disease Management
FORMS: CMS-10061
OMB NO: 0938-0878 EXPIRATION DATE: 10/31/2005
RESPS:6,605,691 HOURS:18,877 COSTS(000):$0
Collection of Diagnostic Data from Medicare+Choice Organizations
for Risk Adjusted Payment Supporting Regulations CFR Part 422
Subpart F & G
FORMS: CMS-10062
OMB NO: 0938-0879 EXPIRATION DATE: 10/31/2005
RESPS:1,350 HOURS:1,012 COSTS(000):$0
Making Good Choices Survey
FORMS: CMS-10065
OMB NO: 0938-0883 EXPIRATION DATE: 12/31/2005
RESPS:776,224,162 HOURS:2,210,715 COSTS(000):$0
Standards for Privacy of Individually Identifiable Health
Information and Supporting Regulations at 45 CFR Parts 160 and
164
FORMS: HCFA-10039
OMB NO: 0938-0887 EXPIRATION DATE: 06/30/2003
RESPS:20 HOURS:800 COSTS(000):$0
Matching Grants to States for the Operation of High Risk Pools
FORMS: CMS-10078
OMB NO: 0970-0004 EXPIRATION DATE: 04/30/2005
RESPS:1 HOURS:13,746 COSTS(000):$0
Annual Statistical Report on Children in Foster Homes and
Children in Famillies Receiving Payment in Excess of the Poverty
Income Level from a Program Funded Under Part A of Title IV....
FORMS: ACF-4125
OMB NO: 0970-0017 EXPIRATION DATE: 09/30/2004
RESPS:54 HOURS:90 COSTS(000):$0
Revised Form OCSE-100, State Plan for Child Support Collection
and Establishment of Paternity Under Title IV-D of the Social
Security Act
FORMS: OCSE-100
OMB NO: 0970-0043 EXPIRATION DATE: 05/31/2003
RESPS:50 HOURS:217 COSTS(000):$0
Refugee State of Origin Report
FORMS: ORR-11
OMB NO: 0970-0060 EXPIRATION DATE: 10/31/2003
RESPS:236 HOURS:2,108 COSTS(000):$0
Low Income Home Energy Assistance Program (LIHEAP) Household
Report
FORMS: NONE
OMB NO: 0970-0062 EXPIRATION DATE: 01/31/2004
RESPS:940 HOURS:20,300 COSTS(000):$0
Information collection from applicants who will respond to
Request for Applications for funding of OCS competitive grants
FORMS: NONE
OMB NO: 0970-0075 EXPIRATION DATE: 02/28/2005
RESPS:180 HOURS:103 COSTS(000):$0
Application Requirements for the Low Income Home Energy
Assistance Program (LIHEAP) Model Plan
FORMS: NONE
OMB NO: 0970-0076 EXPIRATION DATE: 08/31/2004
RESPS:51 HOURS:178 COSTS(000):$0
The Low Income Home Energy Assistance Program (LIHEAP) Grantee
Survey
FORMS: ACF-284
OMB NO: 0970-0085 EXPIRATION DATE: 12/31/2003
RESPS:44,471 HOURS:593,226 COSTS(000):$0
Provision of Services in Interstate Child Support Enforcement:
Standard Forms
FORMS: NONE
OMB NO: 0970-0106 EXPIRATION DATE: 11/30/2004
RESPS:177 HOURS:531 COSTS(000):$0
Low Income Home Energy Assistance Program (LIHEAP) Carryover and
Reallotment Report
FORMS: NONE
OMB NO: 0970-0114 EXPIRATION DATE: 02/29/2004
RESPS:28 HOURS:4,552 COSTS(000):$0
Child Care and Development Fund Plan for States/Territories
FORMS: ACF-118
OMB NO: 0970-0121 EXPIRATION DATE: 07/31/2003
RESPS:70 HOURS:2,660 COSTS(000):$0
Low Income Home Energy Assistance Program (LIHEAP) Leveraging
Report
FORMS: ACF-119
OMB NO: 0970-0123 EXPIRATION DATE: 04/30/2004
RESPS:135,080 HOURS:62,012 COSTS(000):$330
Runaway and Homeless Youth Management Information System
FORMS: NONE
OMB NO: 0970-0160 EXPIRATION DATE: 11/30/2003
RESPS:25 HOURS:500 COSTS(000):$0
Procedures for Requests to Use Child Care and Development Fund
for Construction or Major Renovation of Child Care Facilities
FORMS: NONE
OMB NO: 0970-0161 EXPIRATION DATE: 04/30/2004
RESPS:7,074 HOURS:2,535 COSTS(000):$128
Federal Tax Offset, Administrative Offest, and Passport Denial
Programs
FORMS: NONE
OMB NO: 0970-0163 EXPIRATION DATE: 12/31/2003
RESPS:4 HOURS:1,792 COSTS(000):$3
Child Care and Development Fund Quarterly Financial Report
FORMS: ACF-696
OMB NO: 0970-0166 EXPIRATION DATE: 01/31/2004
RESPS:60,000,000 HOURS:1,962,402 COSTS(000):$86,400
National Directory of New Hires
FORMS: NONE
OMB NO: 0970-0171 EXPIRATION DATE: 07/31/2004
RESPS:448,600 HOURS:74,468 COSTS(000):$0
Required Data Elements for Paternity Establishment Affidavits
FORMS: NONE
OMB NO: 0970-0173 EXPIRATION DATE: 05/31/2004
RESPS:1 HOURS:1,120 COSTS(000):$0
Request for State Data Needed to Determine the Amount of a
Tribal Family Assistance Grant
FORMS: NONE
OMB NO: 0970-0174 EXPIRATION DATE: 03/31/2006
RESPS:79 HOURS:1,575 COSTS(000):$0
Native Employment Works (NEW) Program Plan Guidance and Program
Report
FORMS: NONE
OMB NO: 0970-0186 EXPIRATION DATE: 02/28/2005
RESPS:1 HOURS:15,552 COSTS(000):$0
Information Collection for the Methodology for Determining
Whether an Increase in a State's Child Poverty Rate Is the
Result of the TANF Program(s) in the State
FORMS: NONE
OMB NO: 0970-0195 EXPIRATION DATE: 03/31/2005
RESPS:232 HOURS:1,856 COSTS(000):$0
Child Care and Development Fund Annual Financial Report for
Tribes
FORMS: ACF-696T
OMB NO: 0970-0196 EXPIRATION DATE: 08/31/2004
RESPS:17,173 HOURS:8,586 COSTS(000):$157
Financial Institution Data Match
FORMS: NONE
OMB NO: 0970-0198 EXPIRATION DATE: 06/30/2005
RESPS:262 HOURS:4,978 COSTS(000):$0
Child Care and Development Fund Tribal Plan
FORMS: ACF-118-A
OMB NO: 0970-0199 EXPIRATION DATE: 04/30/2003
RESPS:208 HOURS:586,864 COSTS(000):$13,500
TANF Data Report (Includes TANF Sampling and Statistical Methods
Manual), SSP-MOE Data report (Includes TANF Sampling and
Statistical Methods Manual
FORMS: ACF-199 ACF-209
OMB NO: 0970-0202 EXPIRATION DATE: 09/30/2005
RESPS:15,839 HOURS:20,948 COSTS(000):$0
National Survey of Child and Adolescent Well-Being (Child
Welfare Longitudinal Study)
FORMS: NONE
OMB NO: 0970-0205 EXPIRATION DATE: 05/31/2004
RESPS:4 HOURS:5,200 COSTS(000):$0
IV-E Foster Care and Adoption Assistance Financial Report
FORMS: ACF-IV-E-1
OMB NO: 0970-0207 EXPIRATION DATE: 04/30/2003
RESPS:1,513 HOURS:49,929 COSTS(000):$998
Head Start Program Grant Application
FORMS: NONE
OMB NO: 0970-0214 EXPIRATION DATE: 04/30/2003
RESPS:39 HOURS:17,621 COSTS(000):$0
Title IV-E Foster Care Eligibility Reviews, Child and Family
Services Reviews, Section 471(a)(18) Compliance Reviews
FORMS: NONE
OMB NO: 0970-0215 EXPIRATION DATE: 05/31/2003
RESPS:216 HOURS:68,544 COSTS(000):$198
Final Tribal TANF Data Report
FORMS: ACF-343
OMB NO: 0970-0218 EXPIRATION DATE: 09/30/2003
RESPS:990 HOURS:29,464 COSTS(000):$0
Tribal Child Support Enforcement Direct Funding Request and
Reports -- Notice of Proposed Rulemaking and Interim Final Rule
FORMS: NONE
OMB NO: 0970-0221 EXPIRATION DATE: 11/30/2003
RESPS:216 HOURS:216 COSTS(000):$0
State Systems Profiles
FORMS: NONE
OMB NO: 0970-0222 EXPIRATION DATE: 12/31/2003
RESPS:2,234 HOURS:120,653 COSTS(000):$22
National Medical Support Notice - Final Rule
FORMS: NONE
OMB NO: 0970-0223 EXPIRATION DATE: 01/31/2004
RESPS:54 HOURS:208,764 COSTS(000):$450
State Self-Assessemtn Review and Report
FORMS: NONE
OMB NO: 0970-0226 EXPIRATION DATE: 09/30/2004
RESPS:1,404 HOURS:975 COSTS(000):$0
Study of the TANF Application Process
FORMS: NONE
OMB NO: 0970-0229 EXPIRATION DATE: 09/30/2005
RESPS:19,237 HOURS:13,745 COSTS(000):$0
Head Start Impact Study (HSIS)
FORMS: NONE
OMB NO: 0970-0230 EXPIRATION DATE: 07/31/2005
RESPS:108 HOURS:1,728 COSTS(000):$0
TANF High Performance Bonus for Fiscal Year 2002, Electronic
Transmission File Layouts and Federal System Edits on Work
Measures
FORMS: ACF-300
OMB NO: 0970-0249 EXPIRATION DATE: 08/31/2003
RESPS:2,634 HOURS:3,584 COSTS(000):$0
Design and Field Testing of Head Start National Reporting System
on Child Outcomes
FORMS: NONE
OMB NO: 0980-0017 EXPIRATION DATE: 11/30/2004
RESPS:2,437 HOURS:9,748 COSTS(000):$0
Head Start Program Information Report
FORMS: NONE
OMB NO: 0980-0047 EXPIRATION DATE: 07/31/2005
RESPS:300 HOURS:112,500 COSTS(000):$0
Child and Family Services Plan (CFSP), Annual Progress and
Services Reprot (APSR), and Annual Budget Expenses Request and
Estimated Expenditures (CFS-101)
FORMS: CFS-101
OMB NO: 0980-0140 EXPIRATION DATE: 07/31/2004
RESPS:714,056 HOURS:1,872,392 COSTS(000):$0
Case Plan Requirements, Section 422(b); 471(a)(16), 475(5) and
475(6) of the Social Security Act (SSA); 45 CFR 1356.21(f)(g)
FORMS: NONE
OMB NO: 0980-0141 EXPIRATION DATE: 10/31/2005
RESPS:12 HOURS:180 COSTS(000):$0
State Plan for Title IV-E of the Social Security Act: Foster
Care, Independent Living Services and Adoption Assistance
FORMS: NONE
OMB NO: 0980-0160 EXPIRATION DATE: 08/31/2005
RESPS:57 HOURS:2,508 COSTS(000):$2
Developmental Disabilities Protection and Advocacy Program
Performance Report
FORMS: NONE
OMB NO: 0980-0162 EXPIRATION DATE: 09/30/2005
RESPS:1 HOURS:4,400 COSTS(000):$1,650
Developmental Disabilities State Plan
FORMS: NONE
OMB NO: 0980-0172 EXPIRATION DATE: 09/30/2005
RESPS:1 HOURS:2,420 COSTS(000):$2
State Council on Developmental Disabilities Program Performance
Report
FORMS: NONE
OMB NO: 0980-0196 EXPIRATION DATE: 04/30/2005
RESPS:52 HOURS:3,120 COSTS(000):$0
Application and Program Reporting Requirements for Children's
Justice Act Grants
FORMS: NONE
OMB NO: 0980-0204 EXPIRATION DATE: 04/30/2003
RESPS:650 HOURS:18,200 COSTS(000):$0
Program Narrative Objective Work Plan (OWP)
FORMS: NONE
OMB NO: 0980-0212 EXPIRATION DATE: 09/30/2005
RESPS:110 HOURS:990 COSTS(000):$0
Financial Status Reporting Form (SF-269) with Supplemental Form
(ADD-02) for porogam of state council on developmental
disabilities
FORMS: ADD02/SF269
OMB NO: 0980-0229 EXPIRATION DATE: 06/30/2003
RESPS:52 HOURS:4,780 COSTS(000):$63
National Child Abuse and Neglect Data System (NCANDS)
FORMS: NONE
OMB NO: 0980-0241 EXPIRATION DATE: 11/30/2004
RESPS:257 HOURS:8,995 COSTS(000):$0
Child Care and Development Fund Tribal Annual Report
FORMS: ACF-700
OMB NO: 0980-0266 EXPIRATION DATE: 08/31/2004
RESPS:1,505 HOURS:496 COSTS(000):$0
Voluntary Survey of Program Partners to implement Executive
Order 12862 within the Administration for Children Families
FORMS: NONE
OMB NO: 0980-0270 EXPIRATION DATE: 09/30/2003
RESPS:1 HOURS:2,508 COSTS(000):$2
Developmental Disabilities Protection and Advocacy Statement of
Goals and Priorities
FORMS: NONE
OMB NO: 0980-0271 EXPIRATION DATE: 10/31/2004
RESPS:4,021,364 HOURS:221,325 COSTS(000):$259
Computerized Support Enforcement Systems - Final Rule
FORMS: NONE
OMB NO: 0985-0004 EXPIRATION DATE: 08/31/2004
RESPS:112 HOURS:112 COSTS(000):$1,426
Supplemental Form to the Financial Status Report (SF269), Title
III of the Older Americans Act, Grants for State and Community
Programs on Aging
FORMS: NONE
OMB NO: 0985-0005 EXPIRATION DATE: 12/31/2005
RESPS:52 HOURS:7,620 COSTS(000):$58,068
State Annual Long-Term Care Ombudsman Report
FORMS: NONE
OMB NO: 0985-0006 EXPIRATION DATE: 08/31/2004
RESPS:398 HOURS:7,960 COSTS(000):$0
Performance Progress Reports for Title IV Grantees
FORMS: NONE
OMB NO: 0985-0007 EXPIRATION DATE: 07/31/2003
RESPS:2 HOURS:681 COSTS(000):$0
Program Performance Report, Title VI of the Older Americans Act.
(Grants for Native Americans for Nutritional and Supportive
Services)
FORMS: NONE
OMB NO: 0985-0008 EXPIRATION DATE: 01/31/2006
RESPS:1 HOURS:141,132 COSTS(000):$0
State Program Report for Title III and VII of the Older
Americans Act
FORMS: NONE
OMB NO: 0985-0009 EXPIRATION DATE: 07/31/2005
RESPS:56 HOURS:28 COSTS(000):$748
Certification of Maintenance of Effort
FORMS: NONE
OMB NO: 0985-0012 EXPIRATION DATE: 02/28/2005
RESPS:50 HOURS:1,000 COSTS(000):$0
Alzheimer's Disease Demonstration Grants to States Program
Semi-Annual Report and Instructions
FORMS: NONE
OMB NO: 0985-0013 EXPIRATION DATE: 02/28/2005
RESPS:9,250 HOURS:1,713 COSTS(000):$0
Alzheimer's Disease Demonstration Grants to States Program
Evaluation Data Collection
FORMS: NONE
OMB NO: 0985-0014 EXPIRATION DATE: 05/31/2003
RESPS:3,708 HOURS:2,046 COSTS(000):$0
National Survey of Older American Act Participants
FORMS: NONE
OMB NO: 0985-0015 EXPIRATION DATE: 09/30/2003
RESPS:1,600 HOURS:267 COSTS(000):$0
National Family Caregiver Support Program Survey: Grandparents
and Other Relatives Raising Children
FORMS: NONE
OMB NO: 0990-0001 EXPIRATION DATE: 04/30/2003
RESPS:200 HOURS:1,200 COSTS(000):$150
Application for Waiver of the 2-Year Foreign Residence
Requirement of the Exchange Visitor Program
FORMS: HHS-426
OMB NO: 0990-0136 EXPIRATION DATE: 01/31/2006
RESPS:430 HOURS:3,440 COSTS(000):$0
HHS Acquisition Regulation - HHSAR Part 324 - Protection of
Privacy and Freedom of Information
FORMS: NONE
OMB NO: 0990-0139 EXPIRATION DATE: 06/30/2003
RESPS:6,645 HOURS:13,290 COSTS(000):$0
HHS Acquisition Regulation - HHSAR Subpart 315.4 - Solicitation
and Receipt of Proposals and Quotations
FORMS: NONE
OMB NO: 0990-0150 EXPIRATION DATE: 04/30/2004
RESPS:1 HOURS:1 COSTS(000):$0
Uniform Relocation and Real Property Acquisition Under Federal
and Federally Assisted Program
FORMS: NONE
OMB NO: 0990-0169 EXPIRATION DATE: 12/31/2005
RESPS:4,000 HOURS:280,000 COSTS(000):$0
Uniform Administrative Requirements for Grantrs and Cooperative
Agreements to State and Local Governments
FORMS: NONE
OMB NO: 0990-0220 EXPIRATION DATE: 12/31/2003
RESPS:2,400 HOURS:480 COSTS(000):$0
Voluntary Industry Partner Surveys to Implement E.O. 12862
FORMS: NONE
OMB NO: 0990-0221 EXPIRATION DATE: 09/30/2004
RESPS:85 HOURS:1,870 COSTS(000):$47
Title X Family Planning Annual Report
FORMS: NONE
OMB NO: 0990-0223 EXPIRATION DATE: 12/31/2003
RESPS:7,350 HOURS:3,496 COSTS(000):$0
Evaluation of the Cash and Counseling Demonstration
FORMS: NONE
OMB NO: 0990-0230 EXPIRATION DATE: 06/30/2003
RESPS:780 HOURS:930 COSTS(000):$0
Site Visit Protocols for the Multi-site Evaluation of the
Welfare-to-Work Grants Program
FORMS: NONE
OMB NO: 0990-0236 EXPIRATION DATE: 02/29/2004
RESPS:620 HOURS:620 COSTS(000):$0
Financial Summary of Obligation and Expenditure of Block Grant
Funds (45 CFR 96.30)
FORMS: SF-269A
OMB NO: 0990-0237 EXPIRATION DATE: 05/31/2003
RESPS:7,220 HOURS:6,138 COSTS(000):$0
First Follow-up Survey of Youth - Federal Evaluation of
Initiatives Funded Under Section 510 of the Maternal and Child
Health Block Grant Program
FORMS: NONE
OMB NO: 0990-0238 EXPIRATION DATE: 06/30/2003
RESPS:12,750 HOURS:9,819 COSTS(000):$0
Follow-up Survey for the Multi-site Evaluation of the
Welfare-to-Work Grants Program
FORMS: NONE
OMB NO: 0990-0239 EXPIRATION DATE: 06/30/2003
RESPS:136 HOURS:46 COSTS(000):$0
Empowerment Zone and Enterprise Community Health Improvement
Capacity Survey
FORMS: NONE
OMB NO: 0990-0240 EXPIRATION DATE: 07/31/2003
RESPS:3,555 HOURS:666 COSTS(000):$0
Survey of Grant Recipients
FORMS: NONE
OMB NO: 0990-0244 EXPIRATION DATE: 03/31/2004
RESPS:3,000 HOURS:1,000 COSTS(000):$0
National Centers of Excellence in Women's Health Program
Quantitative Evaluation Survey
FORMS: NONE
OMB NO: 0990-0250 EXPIRATION DATE: 10/31/2004
RESPS:600 HOURS:150 COSTS(000):$0
National Centers of Excellence in Women's Health Program
Supplemental Quantiative Community Survey
FORMS: NONE
OMB NO: 0990-0253 EXPIRATION DATE: 06/30/2004
RESPS:1,104 HOURS:1,288 COSTS(000):$0
National Study of Child Protective Services Systems and Reform
Efforts
FORMS: NONE
OMB NO: 0990-0255 EXPIRATION DATE: 06/30/2003
RESPS:720 HOURS:300 COSTS(000):$0
National Study of Culturally and Linguistically Appropriate
Services in Managed Care Organization
FORMS: NONE
OMB NO: 0990-0256 EXPIRATION DATE: 02/28/2005
RESPS:21,600 HOURS:12,744 COSTS(000):$0
Survey of SCHIP Enrollees and Disenrollees for the
Congressionally Mandated Evaluation of the State Children's
Health Insurance Program
FORMS: NONE
OMB NO: 0990-0257 EXPIRATION DATE: 05/31/2005
RESPS:2,872 HOURS:1,436 COSTS(000):$0
Wave Three Survey of Youth for the Evaluation of Initiatives
Funded Under Section 510 of the Maternal & Child Health Block
Grant
FORMS: NONE
OMB NO: 0990-0258 EXPIRATION DATE: 05/31/2005
RESPS:2,044 HOURS:1,515 COSTS(000):$0
A Study of Stroke Post-Acute Care Outcomes
FORMS: NONE
OMB NO: 0990-0260 EXPIRATION DATE: 05/31/2005
RESPS:88,566 HOURS:194,376 COSTS(000):$0
Protection of Human Subjects: Common Rule (56 FR 28003)
FORMS: NONE
OMB NO: 0990-0262 EXPIRATION DATE: 06/30/2003
RESPS:1 HOURS:1,250 COSTS(000):$0
Survey of Research Integrity Measures Utilized in Biomedical
Research Laboratories
FORMS: NONE
OMB NO: 0990-0263 EXPIRATION DATE: 07/31/2005
RESPS:17,000 HOURS:1 COSTS(000):$0
Protection of Human Subjects Assurance Identification/IRB
Certification/Declaration of Exemption
FORMS: NONE
OMB NO: 0990-0264 EXPIRATION DATE: 06/30/2005
RESPS:6,640 HOURS:4,378 COSTS(000):$0
State Studies on TANF Caseload
FORMS: NONE
OMB NO: 0990-0265 EXPIRATION DATE: 12/31/2003
RESPS:120 HOURS:480 COSTS(000):$0
Assessment of State Laws, Regulations, and Practice Affecting
the Collection and Reporting of Racial/Ethnic Health Data
FORMS: NONE
OMB NO: 0990-0267 EXPIRATION DATE: 02/28/2006
RESPS:1,252 HOURS:1,138 COSTS(000):$0
Study of Fathers' Involvement in Permanency Planning and Child
Welfare Casework
FORMS: NONE
OMB NO: 0990-0268 EXPIRATION DATE: 09/30/2005
RESPS:6,755 HOURS:3,720 COSTS(000):$0
Service Use and Transition of Private Long-term Care Insurance
FORMS: NONE
OMB NO: 0992-0005 EXPIRATION DATE: 05/31/2003
RESPS:260 HOURS:5,752 COSTS(000):$0
45 CFR Part 95, Subpart F -- Automatic Data Processing Equipment
and Services--Conditions for Federal Financial Participation
FORMS: NONE
OMB NO: 0992-0007 EXPIRATION DATE: 07/31/2004
RESPS:216 HOURS:4,320 COSTS(000):$0
TANF High Performance Bonus Report, Assessment of Medicaid and
SCHIP Enrollment Among Individuals After Leaving TANF Assistance
FORMS: ACF-210
OMB NO: 1615-0002 EXPIRATION DATE: 11/30/2005
RESPS:400,000 HOURS:400,000 COSTS(000):$126,000
LIFE Legalization Supplement to Form I-485 Instructions
FORMS: I-485
OMB NO: 1615-0003 EXPIRATION DATE: 07/31/2004
RESPS:683,210 HOURS:512,407 COSTS(000):$81,985
Application to Extend/Change Nonimmigrant Status
FORMS: I-539
OMB NO: 1615-0004 EXPIRATION DATE: 11/30/2004
RESPS:427,000 HOURS:213,500 COSTS(000):$0
Supplement A to form I-539 (Filing Instructions for V
Nonimmigrant Status)
FORMS: I-539-SUPP.A
OMB NO: 1615-0005 EXPIRATION DATE: 11/30/2004
RESPS:40,000 HOURS:100,000 COSTS(000):$6,600
Application for Benefits Under the Family Unity Program
FORMS: I-817
OMB NO: 1615-0006 EXPIRATION DATE: 04/30/2003
RESPS:15,000 HOURS:16,200 COSTS(000):$5,250
Checklist for On-Site Review of Schools
FORMS: NONE
OMB NO: 1615-0016 EXPIRATION DATE: 06/30/2003
RESPS:300 HOURS:75 COSTS(000):$51
Application for Advance Permission to Return to Unrelinquished
Domicile
FORMS: I-191
OMB NO: 1615-0017 EXPIRATION DATE: 01/31/2005
RESPS:12,000 HOURS:3,000 COSTS(000):$2,040
Application for Advance Permission to Enter as Nonimmigrant
(Pusuant to 212(d)(3) of the Immigration and Nationality Act)
FORMS: FORM-I-192
OMB NO: 1615-0018 EXPIRATION DATE: 11/30/2005
RESPS:4,200 HOURS:8,400 COSTS(000):$819
Application for Permission to reapply for Admission into the
United States after Deportation or Removal
FORMS: I-212
OMB NO: 1615-0020 EXPIRATION DATE: 02/28/2005
RESPS:8,397 HOURS:16,794 COSTS(000):$1,071
Petition ofr Amerasian, Widow or Special Immigrant
FORMS: I-360
OMB NO: 1615-0021 EXPIRATION DATE: 12/31/2005
RESPS:50 HOURS:25 COSTS(000):$0
Affidavit of Financial Support and Intent to Petition for Legal
Custody for Public Law 97-359 Amerasian
FORMS: I-361
OMB NO: 1615-0022 EXPIRATION DATE: 10/31/2004
RESPS:50 HOURS:25 COSTS(000):$0
Request to Enforce Affidavit of Financial Support and Intent to
Petition for custody for Pub.L. 97-359 Amerasian
FORMS: I-363
OMB NO: 1615-0023 EXPIRATION DATE: 05/31/2005
RESPS:635,500 HOURS:2,781,321 COSTS(000):$193,256
Application to Register Permanent Residence or Adjust Status,
and Supplement A to Form I-485
FORMS: I-485 SUPP.A-I-485
OMB NO: 1615-0024 EXPIRATION DATE: 12/31/2005
RESPS:50,000 HOURS:25,000 COSTS(000):$0
HRIFA Supplement to Form I-485 Instructions
FORMS: I-485-SUPP.C
OMB NO: 1615-0025 EXPIRATION DATE: 06/30/2005
RESPS:1,800 HOURS:150 COSTS(000):$0
Waiver of Rights, Privileges, Exemptions and Immunities
FORMS: I-508
OMB NO: 1615-0027 EXPIRATION DATE: 05/31/2003
RESPS:4,400 HOURS:1,100 COSTS(000):$0
Inter-Agency Record of Individual Requesting Change/Adjustment
to or form A or g Status; or Requesting A, G. or NATO Dependent
Employment Authorization
FORMS: I-566
OMB NO: 1615-0028 EXPIRATION DATE: 06/30/2005
RESPS:34,000 HOURS:17,000 COSTS(000):$15,640
Petition to Classify Orphan as an Immediate Relative and
Application for Advance Processing of Orphan Petition
FORMS: I-600 I-600A
OMB NO: 1615-0029 EXPIRATION DATE: 06/30/2003
RESPS:3,000 HOURS:1,500 COSTS(000):$510
Application for Waiver of Ground of Excludability
FORMS: I-601
OMB NO: 1615-0030 EXPIRATION DATE: 06/30/2005
RESPS:1,300 HOURS:432 COSTS(000):$253
Application for Waiver of the Foreign Residence Requirement of
Section 212(e) of the Immigration and Nationality Act
FORMS: I-612
OMB NO: 1615-0031 EXPIRATION DATE: 07/31/2005
RESPS:3,000 HOURS:249 COSTS(000):$0
Supplementary Statement for Graduate Medical Trainees
FORMS: I-644
OMB NO: 1615-0032 EXPIRATION DATE: 09/30/2005
RESPS:85 HOURS:21 COSTS(000):$3
Application for Waiver of Grounds of Excludability
FORMS: I-690
OMB NO: 1615-0033 EXPIRATION DATE: 04/30/2005
RESPS:800,000 HOURS:1,200,000 COSTS(000):$0
Medical Examination of Aliens Seeking Adjustment of Status
FORMS: I-693
OMB NO: 1615-0034 EXPIRATION DATE: 06/30/2005
RESPS:1,192 HOURS:596 COSTS(000):$60
Notice of Appeal of Decision Under Section 210 or 245A of the
Immigration and Nationality Act
FORMS: I-694
OMB NO: 1615-0035 EXPIRATION DATE: 11/30/2004
RESPS:1,179 HOURS:1,179 COSTS(000):$141
Application to Adjust Status from Temporary to Permanent Resident
FORMS: I-698
OMB NO: 1615-0041 EXPIRATION DATE: 06/30/2003
RESPS:15,000 HOURS:26,250 COSTS(000):$0
Liberian Deferred Enforced Departure (DED) Supplement to Form
I-765
FORMS: I-765D
OMB NO: 1615-0042 EXPIRATION DATE: 03/31/2004
RESPS:100 HOURS:50 COSTS(000):$2
Application for Issuance or Replacement of Nothern Mariana Card
FORMS: I-777
OMB NO: 1615-0043 EXPIRATION DATE: 03/31/2004
RESPS:181,000 HOURS:90,500 COSTS(000):$8,800
Application for Temporary Protected Status
FORMS: I-821 I-821A
OMB NO: 1615-0044 EXPIRATION DATE: 03/31/2004
RESPS:43,772 HOURS:18,209 COSTS(000):$5,253
Application for Action on an Approved Application or Petition
FORMS: I-824
OMB NO: 1615-0045 EXPIRATION DATE: 12/31/2005
RESPS:200 HOURS:216 COSTS(000):$79
Petition by Entrepreneur to Remove Conditions
FORMS: I-829
OMB NO: 1615-0046 EXPIRATION DATE: 09/30/2005
RESPS:125 HOURS:531 COSTS(000):$0
Interagency Alien Witness and Informant Record
FORMS: I-854
OMB NO: 1615-0048 EXPIRATION DATE: 01/31/2005
RESPS:80,000 HOURS:40,000 COSTS(000):$8,000
Request for Premium Processing Service
FORMS: I-907
OMB NO: 1615-0049 EXPIRATION DATE: 12/31/2005
RESPS:1,000 HOURS:250 COSTS(000):$0
Request for Verification of Naturalization
FORMS: N-25
OMB NO: 1615-0050 EXPIRATION DATE: 07/31/2005
RESPS:7,669 HOURS:21,090 COSTS(000):$1,495
Request for Hearing on a Decision in Naturalization Proceedings
Under Section 336
FORMS: N-336
OMB NO: 1615-0053 EXPIRATION DATE: 02/29/2004
RESPS:45,000 HOURS:33,750 COSTS(000):$0
Request for Certification of Military or Naval Service
FORMS: N-426
OMB NO: 1615-0055 EXPIRATION DATE: 07/31/2005
RESPS:100 HOURS:17 COSTS(000):$9
Application for Transfer of Petition for Naturalization
FORMS: N-455
OMB NO: 1615-0056 EXPIRATION DATE: 08/31/2003
RESPS:375 HOURS:375 COSTS(000):$43
Application to Preserve Residence for Naturalization
FORMS: N-470
OMB NO: 1615-0057 EXPIRATION DATE: 07/31/2005
RESPS:88,500 HOURS:88,500 COSTS(000):$15,932
Application for Certificate of Citizenship
FORMS: N-600
OMB NO: 1615-0058 EXPIRATION DATE: 06/30/2003
RESPS:11,159 HOURS:11,159 COSTS(000):$1,395
Application for Certificate of Citizenship in Behalf of an
Adopted Child
FORMS: N-643
OMB NO: 1615-0066 EXPIRATION DATE: 01/31/2004
RESPS:5 HOURS:1,040,850 COSTS(000):$0
The Student and Exchange Visitor Information System (SEVIS)
FORMS: NONE
OMB NO: 1615-0067 EXPIRATION DATE: 04/30/2003
RESPS:78,000 HOURS:936,000 COSTS(000):$780
Application for Asylum and for Withholding of Removal
FORMS: I-589
OMB NO: 1615-0068 EXPIRATION DATE: 10/31/2005
RESPS:140,000 HOURS:81,620 COSTS(000):$0
Registration for Classification as a Refugee
FORMS: FORM-I-590
OMB NO: 1615-0069 EXPIRATION DATE: 07/31/2005
RESPS:2,500 HOURS:625 COSTS(000):$0
Application by Refugee for Waiver of Grounds of Excludability
FORMS: I-602
OMB NO: 1615-0070 EXPIRATION DATE: 01/31/2004
RESPS:195,000 HOURS:32,370 COSTS(000):$0
Health and Human Services Statistical Data for Refugee/Asylee
Adjusting Status
FORMS: I-643
OMB NO: 1615-0071 EXPIRATION DATE: 10/31/2005
RESPS:5,000 HOURS:2,500 COSTS(000):$0
ABC Change of Address Form and Special Filing Instructions for
ABC Class Members
FORMS: I-855 M-426
OMB NO: 1615-0072 EXPIRATION DATE: 02/28/2006
RESPS:55,000 HOURS:660,000 COSTS(000):$11,825
Application for Suspension of Deportation or Special Rule
Cancellation of Removal (Pursuant to Sec. 203 of Pub. L. 105-100)
FORMS: I-881
OMB NO: 1615-0073 EXPIRATION DATE: 07/31/2005
RESPS:20 HOURS:1,600 COSTS(000):$0
Guidelines on Producing Master Exhibits for Asylum Applications
FORMS: NONE
OMB NO: 1615-0075 EXPIRATION DATE: 08/31/2004
RESPS:950,300 HOURS:2,443,350 COSTS(000):$0
Affidavit of Support Under Sction 213A of the Act, and Contract
Between Sponsor and Household Member
FORMS: I-864
OMB NO: 1615-0076 EXPIRATION DATE: 08/31/2004
RESPS:100,000 HOURS:23,300 COSTS(000):$0
Sponsor's Notice of Change of Address
FORMS: I-865
OMB NO: 1615-0077 EXPIRATION DATE: 04/30/2004
RESPS:150,000 HOURS:75,000 COSTS(000):$0
Generic Clearance of Customer Service Surveys (PREMIUM
PROCESSING SURVEY)
FORMS: OMB-9
OMB NO: 1615-0078 EXPIRATION DATE: 02/29/2004
RESPS:433 HOURS:325 COSTS(000):$21
Application to File Declaration of Intention
FORMS: N-300
OMB NO: 1615-0080 EXPIRATION DATE: 01/31/2006
RESPS:1,000,000 HOURS:75,000 COSTS(000):$0
INS Case Status Online
FORMS: NONE
OMB NO: 1615-0081 EXPIRATION DATE: 06/30/2003
RESPS:5,000 HOURS:2,500 COSTS(000):$0
Application Requirements for the Adjustment of Status Under
Section 586 of Public Law 106-249
FORMS: NONE
OMB NO: 1625-0001 EXPIRATION DATE: 01/31/2005
RESPS:181,089 HOURS:19,195 COSTS(000):$0
Marine Casualty Information; Chemical Drug and Alcohol Testing
of Commercial Vessel Personnel; and Management Information
System Requirements
FORMS: CG-2692 CG-2692A CG-2692B CG-5573
OMB NO: 1625-0002 EXPIRATION DATE: 08/31/2003
RESPS:2,443 HOURS:613 COSTS(000):$0
Application for Vessel Inspection and Waiver
FORMS: CG-2633 CG-3752
OMB NO: 1625-0004 EXPIRATION DATE: 02/29/2004
RESPS:13,600 HOURS:6,640 COSTS(000):$0
U.S. Coast Guard Academy Preliminary Application and
Supplemental Forms
FORMS: NONE
OMB NO: 1625-0005 EXPIRATION DATE: 04/30/2005
RESPS:265 HOURS:292 COSTS(000):$0
Application and Permit to Handle Hazardous Material
FORMS: CG-4260
OMB NO: 1625-0007 EXPIRATION DATE: 01/31/2004
RESPS:43 HOURS:129 COSTS(000):$0
Characteristics of Liquid Chemicals Proposed for Bulk Water
Movement
FORMS: CG-4355
OMB NO: 1625-0011 EXPIRATION DATE: 07/31/2005
RESPS:1 HOURS:3,073 COSTS(000):$0
CG-2554 Private Aids to Navigation Application. CG-4143
Application for Class I Private Aids to Nav artificial
islands/fixed structures
FORMS: CG-2554 CG-4143
OMB NO: 1625-0012 EXPIRATION DATE: 07/31/2003
RESPS:130,000 HOURS:4,500 COSTS(000):$0
Certificate of Discharge to Merchant Mariners
FORMS: CG-718A
OMB NO: 1625-0013 EXPIRATION DATE: 05/31/2005
RESPS:20,495 HOURS:1,979 COSTS(000):$0
Plan Approval and Records for Load Lines
FORMS: 98-USA-LL A21-HSSC-LL- EXEMPT LL-14-A LL-18-E LL-40-A LL-19
LL-13-C LL-18-F
OMB NO: 1625-0014 EXPIRATION DATE: 08/31/2003
RESPS:29 HOURS:29 COSTS(000):$0
Request for Designation and Exemption of Oceanographic Research
Vessels
FORMS: NONE
OMB NO: 1625-0019 EXPIRATION DATE: 09/30/2004
RESPS:34 HOURS:153 COSTS(000):$0
Alternative Compliance for International and Inland Navigation
Rules -- 33 CFR Parts 81 and 89
FORMS: NONE
OMB NO: 1625-0020 EXPIRATION DATE: 01/31/2005
RESPS:333 HOURS:417 COSTS(000):$0
Security Zones, Regulated Navigation Areas, and Safety Zones
FORMS: NONE
OMB NO: 1625-0021 EXPIRATION DATE: 03/31/2005
RESPS:1,012 HOURS:27,369 COSTS(000):$0
Operations Manual and Amendments for Facilities Transferring Oil
and Hazardous Materials in Bulk
FORMS: NONE
OMB NO: 1625-0022 EXPIRATION DATE: 04/30/2003
RESPS:12,720 HOURS:27,600 COSTS(000):$0
Application for Tonnage Measurement of Vessels
FORMS: CG-5397
OMB NO: 1625-0025 EXPIRATION DATE: 07/31/2004
RESPS:1,538 HOURS:830 COSTS(000):$0
Carriage of Bulk Solids Requiring Special Handling -- 46 CFR
Part 148
FORMS: NONE
OMB NO: 1625-0026 EXPIRATION DATE: 09/30/2003
RESPS:61 HOURS:65 COSTS(000):$0
Plan Approval and Records for Foreign Vessels Carrying Oil in
Bulk
FORMS: NONE
OMB NO: 1625-0032 EXPIRATION DATE: 06/30/2005
RESPS:3,405 HOURS:1,578 COSTS(000):$0
Vessel Inspection Related Forms and Posting Requirements Under
Title 46 U.S. Code
FORMS: CG-841 CG-854 CG-948 CG-949 CG-950 CG-950A CG-2832 CG-4504
OMB NO: 1625-0033 EXPIRATION DATE: 09/30/2003
RESPS:1,596 HOURS:798 COSTS(000):$0
Display of Fire Control Plans for Vessels
FORMS: NONE
OMB NO: 1625-0035 EXPIRATION DATE: 12/31/2005
RESPS:2,178 HOURS:16,880 COSTS(000):$0
Title 46 CFR Subchapter Q: Lifesaving, Electrical, and
Engineering Equipment, Construction and Materials (Consolidates
COIs 2115-0121, 0141, 0525, 0576, 0577 & 0619)
FORMS: 10030
OMB NO: 1625-0036 EXPIRATION DATE: 12/31/2004
RESPS:2,023 HOURS:443 COSTS(000):$0
Plan Approval and Records for Vessels Carrying Oil in Bulk
FORMS: NONE
OMB NO: 1625-0037 EXPIRATION DATE: 07/31/2005
RESPS:36,656 HOURS:17,555 COSTS(000):$0
Tank Vessel Examination Letters, Certificates of Compliance,
Boiler/Pressure Vessel Repairs, Cargo Gear Records, and Shipping
Papers
FORMS: CG-840S-1 CG-840S-2 CG-3583
OMB NO: 1625-0038 EXPIRATION DATE: 08/31/2003
RESPS:11,963 HOURS:6,472 COSTS(000):$0
Plan Approval & Records for Tank, Passenger, Cargo & Miscellan-
eous Vessels, Mobile Off-shore Drilling Units, Nautical Schools,
Oceanographic Vessels & Electrictal Engineering
FORMS: NONE
OMB NO: 1625-0039 EXPIRATION DATE: 08/31/2003
RESPS:92,283 HOURS:28,332 COSTS(000):$0
Declaration of Inspection Before Transfer of Liquid Cargo in Bulk
FORMS: NONE
OMB NO: 1625-0040 EXPIRATION DATE: 01/31/2005
RESPS:48,029 HOURS:21,358 COSTS(000):$0
Submission of continuous discharge book, revised merchant
mariner application, physical report new sea service, chemical
testing and entry level physical forms.
FORMS: CG-719A CG-719B CG-719K CG-719S CG-719P CG-719K/E
OMB NO: 1625-0042 EXPIRATION DATE: 07/31/2005
RESPS:1,300 HOURS:228 COSTS(000):$0
Requirements for Lightering of Oil and Hazardous Material Cargoes
FORMS: NONE
OMB NO: 1625-0043 EXPIRATION DATE: 09/30/2005
RESPS:1,339 HOURS:2,929 COSTS(000):$0
Ports and Waterways Safety -- Title 33 CFR Subchapter P
FORMS: NONE
OMB NO: 1625-0044 EXPIRATION DATE: 09/30/2003
RESPS:263 HOURS:526 COSTS(000):$0
Station Bill for Manned Outer Continental Shelf Facilities
FORMS: NONE
OMB NO: 1625-0049 EXPIRATION DATE: 01/31/2004
RESPS:463 HOURS:3,272 COSTS(000):$0
Liquefied Natural Gas and Liquefied Hazardous Gas Waterfront
Facilities
FORMS: NONE
OMB NO: 1625-0050 EXPIRATION DATE: 12/31/2004
RESPS:5 HOURS:50 COSTS(000):$0
Approval of Equivalent Equipment or Procedures Other than those
Specified in Title 33 CFR Subchapter N
FORMS: NONE
OMB NO: 1625-0051 EXPIRATION DATE: 11/30/2005
RESPS:30 HOURS:10 COSTS(000):$0
a) Reports of MARPOL 73/78 oil, noxious liquid substance (NLS)
and garbage discharge; b) Application for equivalents,
exemptions and alternatives; c) Pollution sightings
FORMS: NONE
OMB NO: 1625-0052 EXPIRATION DATE: 09/30/2003
RESPS:13 HOURS:84 COSTS(000):$0
Nondestructive Testing Proposal and Results for Pressure Vessel
Cargo Tanks on Unmanned Barges
FORMS: NONE
OMB NO: 1625-0053 EXPIRATION DATE: 01/31/2004
RESPS:15 HOURS:46 COSTS(000):$0
Hopper Dredge Working Freeboard - - Load Line and Stability
FORMS: NONE
OMB NO: 1625-0055 EXPIRATION DATE: 01/31/2004
RESPS:13 HOURS:143 COSTS(000):$0
Alternative Provisions for Reinspection of Offshore Supply
Vessels in Foreign Ports
FORMS: NONE
OMB NO: 1625-0056 EXPIRATION DATE: 08/31/2003
RESPS:261 HOURS:382,798 COSTS(000):$0
Labeling Requirements in 33 CFR Parts 181 and 183
FORMS: NONE
OMB NO: 1625-0057 EXPIRATION DATE: 09/30/2003
RESPS:6,753 HOURS:436,173 COSTS(000):$0
Small Passenger Vessels -- Title 46 CFR Subchapters K and T
FORMS: CG-841 CG-854 CG-948 CG-949 CG-3752 CG-5256
OMB NO: 1625-0058 EXPIRATION DATE: 12/31/2004
RESPS:350 HOURS:391 COSTS(000):$0
Application for Permit to Transport Municipal and Commercial
Waste
FORMS: NONE
OMB NO: 1625-0059 EXPIRATION DATE: 06/30/2004
RESPS:268 HOURS:884 COSTS(000):$0
Outer Continental Shelf Activities -- Emergency Evacuation Plans
for Manned OCS Facilities; Design & Plan Approvals; In-service
Inspection & Letter of Compliance
FORMS: NONE
OMB NO: 1625-0060 EXPIRATION DATE: 07/31/2005
RESPS:122 HOURS:1,073 COSTS(000):$0
Vapor Control Systems for Facilities and Tank Vessels
FORMS: NONE
OMB NO: 1625-0062 EXPIRATION DATE: 10/31/2004
RESPS:1 HOURS:18 COSTS(000):$0
Approval of Alterations to Marine Portable Tanks; Approval of
Non-Specification Portable Tanks
FORMS: NONE
OMB NO: 1625-0063 EXPIRATION DATE: 06/30/2003
RESPS:200 HOURS:59,755 COSTS(000):$0
Marine Occupational Health and Safety Standards for Benzene--46
CFR 197 Subpart C
FORMS: NONE
OMB NO: 1625-0064 EXPIRATION DATE: 01/31/2004
RESPS:3,250 HOURS:10,003 COSTS(000):$0
Plan Approval and Records for Subdivision and Stability
Regulations--Title 46 CFR Subchapter S
FORMS: NONE
OMB NO: 1625-0066 EXPIRATION DATE: 08/31/2003
RESPS:5,207 HOURS:188,733 COSTS(000):$0
Vessel Response Plans, Facility Response Plans, Shipboard Oil
Pollution Emergency Plans, and Additional Response Equipment
Requirements for Prince William Sound
FORMS: NONE
OMB NO: 1625-0067 EXPIRATION DATE: 04/30/2005
RESPS:831 HOURS:13,722 COSTS(000):$0
Claims under the Oil Pollution Act of 1990
FORMS: NONE
OMB NO: 1625-0068 EXPIRATION DATE: 04/30/2005
RESPS:1 HOURS:3 COSTS(000):$0
State access to the oil spill liability trust fund for removal
costs under the Oil Pollution Act of 1990
FORMS: NONE
OMB NO: 1625-0069 EXPIRATION DATE: 11/30/2005
RESPS:50,000 HOURS:33,500 COSTS(000):$0
Ballast Water Management for Vessels with Ballast Tanks Entering
U.S. Waters
FORMS: CG-5662
OMB NO: 1625-0072 EXPIRATION DATE: 04/30/2004
RESPS:5,707 HOURS:59,653 COSTS(000):$0
Waste Management Plans, Refuse Discharge Logs, and Letters of
Instruction for Certain Persons-in-Charge (PIC)
FORMS: NONE
OMB NO: 1625-0073 EXPIRATION DATE: 06/30/2003
RESPS:3 HOURS:120 COSTS(000):$0
Alteration of Unreasonably Obstructive Bridges under the
Truman-Hobbs (T-H) Act
FORMS: NONE
OMB NO: 1625-0074 EXPIRATION DATE: 02/29/2004
RESPS:18,823 HOURS:4,648 COSTS(000):$0
Direct User Fees for Inspection or Examination of U.S. and
Foreign Commercial Vessels
FORMS: CG-5565 CG-5565A
OMB NO: 1625-0076 EXPIRATION DATE: 09/30/2004
RESPS:50 HOURS:1,406 COSTS(000):$0
Inflatable Personal Flotation Devices for Recreational Vessels
FORMS: NONE
OMB NO: 1625-0077 EXPIRATION DATE: 06/30/2003
RESPS:95 HOURS:1,811 COSTS(000):$0
Security of Passenger Vessels and Passenger Terminals
FORMS: NONE
OMB NO: 1625-0078 EXPIRATION DATE: 05/31/2004
RESPS:226 HOURS:15,338 COSTS(000):$0
Licensing and Manning Requirements for Officers on Towing Vessels
FORMS: NONE
OMB NO: 1625-0079 EXPIRATION DATE: 02/28/2006
RESPS:14,995 HOURS:18,693 COSTS(000):$0
Standards of Training, Certification and Watchkeeping for
Seafarers (STCW), 1995 and 1997 Amendments to the International
Convention
FORMS: NONE
OMB NO: 1625-0087 EXPIRATION DATE: 03/31/2005
RESPS:300 HOURS:125 COSTS(000):$0
U.S. Coast Guard International Ice Patrol (IIP) Customer Survey
FORMS: NONE
OMB NO: 1625-0088 EXPIRATION DATE: 10/31/2004
RESPS:877 HOURS:439 COSTS(000):$0
Voyage Planning for Tank Barge Transits in the Northeast United
States
FORMS: NONE
OMB NO: 1625-0089 EXPIRATION DATE: 08/31/2005
RESPS:87,500 HOURS:11,458 COSTS(000):$0
The National Recreational Boating Survey
FORMS: NONE
OMB NO: 1625-0090 EXPIRATION DATE: 09/30/2003
RESPS:2,784 HOURS:1,624 COSTS(000):$0
Understanding How Mariners Use Aids to Navigation - A Tool for
the Coast Guard's Office of Aids to Navigation
FORMS: NONE
OMB NO: 1625-0091 EXPIRATION DATE: 09/30/2003
RESPS:27 HOURS:54 COSTS(000):$0
Certification of Navigation Lights for Recreational and
Uninspected Vessels
FORMS: NONE
OMB NO: 1625-0092 EXPIRATION DATE: 09/30/2004
RESPS:23 HOURS:230 COSTS(000):$0
Sewage and Graywater Discharge Records for Certain Cruise
Vessels Operating on Alaskan Waters
FORMS: NONE
OMB NO: 1625-0093 EXPIRATION DATE: 03/31/2006
RESPS:1,395 HOURS:27,819 COSTS(000):$0
Facilities Transferring Oil or Hazardous Materials in Bulk --
Letter of Intent and Operations Manual
FORMS: NONE
OMB NO: 1625-0095 EXPIRATION DATE: 03/31/2006
RESPS:168 HOURS:1,440 COSTS(000):$0
Oil and Hazardous Material Pollution Prevention and Safety
Records, Equivalents/Alternatives and Exemptions
FORMS: NONE
OMB NO: 1625-0096 EXPIRATION DATE: 03/31/2006
RESPS:104,000 HOURS:8,667 COSTS(000):$0
Report of Oil or Hazardous Substance Discharge
FORMS: NONE
OMB NO: 1625-0097 EXPIRATION DATE: 03/31/2006
RESPS:3,090 HOURS:3,090 COSTS(000):$0
Plan Approval and Records for Marine Engineering Systems - 46
CFR Subchapter F
FORMS: NONE
OMB NO: 1625-0098 EXPIRATION DATE: 03/31/2006
RESPS:6,633 HOURS:442 COSTS(000):$0
Records Relating to Citizenship of Personnel on Units Engaged in
Outer Continental Shelf (OCS) Activities
FORMS: NONE
OMB NO: 1625-0099 EXPIRATION DATE: 03/31/2006
RESPS:5,360 HOURS:2,680 COSTS(000):$0
Requirements for the Use of Liquefied Petroleum Gas and
Compressed Natural Gas as Cooking Fuel on Passenger Vessels
FORMS: NONE
OMB NO: 1625-0100 EXPIRATION DATE: 03/31/2006
RESPS:68,139 HOURS:174,179 COSTS(000):$0
Advance Notice of Vessel Arrival and Departure
FORMS: I-418 1302
OMB NO: 1625-0101 EXPIRATION DATE: 03/31/2006
RESPS:236 HOURS:13,688 COSTS(000):$0
Periodic Gauging and Engineering Analyses for Certain Tank
Vessels Over 30 Years Old
FORMS: NONE
OMB NO: 1625-0103 EXPIRATION DATE: 03/31/2006
RESPS:1,098 HOURS:88 COSTS(000):$0
Mandatory Ship Reporting System for the Northeast and Southest
Coasts of the United States
FORMS: NONE
OMB NO: 1651-0003 EXPIRATION DATE: 09/30/2004
RESPS:560,000 HOURS:56,000 COSTS(000):$0
Transportation Entry and Manifest of Goods Subject to Customs
Inspection and Permit
FORMS: CF-7512
OMB NO: 1651-0004 EXPIRATION DATE: 09/30/2004
RESPS:15,000 HOURS:2,000 COSTS(000):$0
Application for Exportation of Articles under Special Bond
FORMS: FORM-3495
OMB NO: 1651-0011 EXPIRATION DATE: 08/31/2003
RESPS:420,000 HOURS:51,000 COSTS(000):$0
Declaration for Free Entry of Returned American Products
FORMS: FORMS-3311
OMB NO: 1651-0013 EXPIRATION DATE: 10/31/2005
RESPS:99,000 HOURS:8,247 COSTS(000):$0
Entry and Manifest of Merchandise Free of Duty, Carrier's
Certificate and Release
FORMS: 7523
OMB NO: 1651-0014 EXPIRATION DATE: 10/31/2003
RESPS:150,000 HOURS:25,000 COSTS(000):$0
Declaration for Free Entry of Unaccompanied Articles
FORMS: FORM-3299
OMB NO: 1651-0015 EXPIRATION DATE: 06/30/2003
RESPS:16,800 HOURS:348 COSTS(000):$0
Application for Extension of Bond for Temporary Importation
FORMS: FORM-3499
OMB NO: 1651-0032 EXPIRATION DATE: 05/31/2003
RESPS:12,000 HOURS:13,000 COSTS(000):$0
Importers of Merchandise Subject to Actual Use Provisions
FORMS: NONE
OMB NO: 1651-0035 EXPIRATION DATE: 11/30/2003
RESPS:20 HOURS:90 COSTS(000):$0
Holders or Containers Which Enter the United States Duty Free
FORMS: NONE
OMB NO: 1651-0036 EXPIRATION DATE: 01/31/2005
RESPS:165 HOURS:27 COSTS(000):$0
Declaration of Ultimate Consignee That Articles Were Exported
for Temporary Scientific or Educational Purposes
FORMS: NONE
OMB NO: 1651-0037 EXPIRATION DATE: 06/30/2005
RESPS:1,600 HOURS:530 COSTS(000):$0
Entry of Articles for Exhibition
FORMS: NONE
OMB NO: 1651-0038 EXPIRATION DATE: 05/31/2003
RESPS:10,500 HOURS:3,500 COSTS(000):$0
Proof of Use rates of Duty Dependent on Actual Use
FORMS: NONE
OMB NO: 1651-0039 EXPIRATION DATE: 01/31/2005
RESPS:7,500 HOURS:1,880 COSTS(000):$0
Declaration by the Person Who Performed the Processing of Goods
Abroad
FORMS: NONE
OMB NO: 1651-0040 EXPIRATION DATE: 08/31/2005
RESPS:205 HOURS:615 COSTS(000):$0
Establishment of a Container Station
FORMS: NONE
OMB NO: 1651-0041 EXPIRATION DATE: 08/31/2005
RESPS:54 HOURS:162 COSTS(000):$0
Establishment of a Bonded Warehouse
FORMS: NONE
OMB NO: 1651-0042 EXPIRATION DATE: 02/28/2006
RESPS:1,078 HOURS:539 COSTS(000):$0
Disclosure of Information on Vessel Manifest
FORMS: NONE
OMB NO: 1651-0043 EXPIRATION DATE: 08/31/2005
RESPS:2 HOURS:16 COSTS(000):$0
Application for Bonding of Smelting and Refining
FORMS: NONE
OMB NO: 1651-0044 EXPIRATION DATE: 07/31/2003
RESPS:1 HOURS:1 COSTS(000):$0
Free Admittance Under Conditions of Emergency
FORMS: NONE
OMB NO: 1651-0045 EXPIRATION DATE: 08/31/2005
RESPS:9,000 HOURS:4,500 COSTS(000):$0
Application to Receive Free Materials in a Bonded Warehouse
FORMS: NONE
OMB NO: 1651-0056 EXPIRATION DATE: 09/30/2004
RESPS:300 HOURS:25 COSTS(000):$0
Importation of Ethyl Alcohol for Non-Beverage Purposes
FORMS: NONE
OMB NO: 1651-0057 EXPIRATION DATE: 05/31/2003
RESPS:10,000 HOURS:41 COSTS(000):$0
Country of Origin Marking Requirements for Containers or Holders
FORMS: NONE
OMB NO: 1651-0069 EXPIRATION DATE: 08/31/2004
RESPS:6,500 HOURS:2,750 COSTS(000):$0
Voluntary Customer Information Surveys in Support of Executive
Order 12862
FORMS: NONE
OMB NO: 1651-0070 EXPIRATION DATE: 01/31/2005
RESPS:2,000 HOURS:667 COSTS(000):$0
Articles Assembled Abroad with Textile Components Cut to Shape
in the U.S.
FORMS: NONE
OMB NO: 1651-0086 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:1 COSTS(000):$0
Distribution of Continued Dumping and Subsidy Offset to Affected
Domestic Producers
FORMS: NONE
OMB NO: 1651-0087 EXPIRATION DATE: 01/31/2005
RESPS:5,500 HOURS:218 COSTS(000):$0
Application for Exemption from Special Landing Requirements
Overflight/GATE
FORMS: FORM-442
OMB NO: 1651-0088 EXPIRATION DATE: 08/31/2005
RESPS:850,000 HOURS:2,380 COSTS(000):$0
Passenger and Crew Manifest for Passenger Flights
FORMS: NONE
OMB NO: 1651-0089 EXPIRATION DATE: 06/30/2005
RESPS:752,000 HOURS:12,833 COSTS(000):$0
Advance Notice Requirements for Aircraft Landings and Arrivals
FORMS: NONE
OMB NO: 1651-0092 EXPIRATION DATE: 03/31/2006
RESPS:500 HOURS:42 COSTS(000):$0
Application for Withdrawal of Bonded Stores for Fishing Vessels
and Certification of Use
FORMS: 5125
OMB NO: 1651-0093 EXPIRATION DATE: 03/31/2006
RESPS:5,700 HOURS:570 COSTS(000):$0
Declaration of Owner of Merchandise Obtained in Pursuance of
Purchase and Declaration of Importer of Record When Entry is
Made by an Agent
FORMS: 3347 3347-A
OMB NO: 1651-0094 EXPIRATION DATE: 03/31/2006
RESPS:1,500 HOURS:250 COSTS(000):$0
Declaration of a Person Abroad Who Receives and is Returning
Merchandise to the U.S.
FORMS: NONE
OMB NO: 1651-0096 EXPIRATION DATE: 03/31/2006
RESPS:21,660 HOURS:2,513 COSTS(000):$0
Transfer of Cargo to a Container Station
FORMS: NONE
OMB NO: 1651-0097 EXPIRATION DATE: 03/31/2006
RESPS:300 HOURS:75 COSTS(000):$0
Blanket Certification of Chemical Substances
FORMS: NONE
OMB NO: 1651-0098 EXPIRATION DATE: 03/31/2006
RESPS:120,500 HOURS:30,037 COSTS(000):$0
North American Free Trade Agreemtn (NAFTA) Certificate of Origin
FORMS: 434 446
OMB NO: 1651-0099 EXPIRATION DATE: 03/31/2006
RESPS:100 HOURS:50 COSTS(000):$0
Bond Procedures for Articles Subject to Exclusion Orders Issued
by the U.S. International Trade Commission.
FORMS: NONE
OMB NO: 1652-0004 EXPIRATION DATE: 06/30/2003
RESPS:2,820 HOURS:664 COSTS(000):$0
Indirect Air Carrier Security -- 14 CFR Part 109
FORMS: N/A
OMB NO: 1652-0005 EXPIRATION DATE: 01/31/2006
RESPS:229 HOURS:5,193 COSTS(000):$0
Security Programs for Foreign Air Carriers
FORMS: 1650-17 1650-8
OMB NO: 1652-0006 EXPIRATION DATE: 06/30/2003
RESPS:1,305 HOURS:16,297 COSTS(000):$0
Employment Standards, FAR Part 107 and FAR Part 108
FORMS: NONE
OMB NO: 1652-0007 EXPIRATION DATE: 02/28/2005
RESPS:1 HOURS:5,193 COSTS(000):$0
Security Programs for Foreign Air Carriers, 14 CFR Part 129
FORMS: NONE
OMB NO: 1652-0010 EXPIRATION DATE: 08/31/2003
RESPS:4 HOURS:20 COSTS(000):$0
Transportation of Explosives from Canada to the United States
Via Commercial Motor Carriers and Rail
FORMS: NONE
OMB NO: 1653-0017 EXPIRATION DATE: 01/31/2004
RESPS:1,500,400 HOURS:26,000 COSTS(000):$0
Inspection of Persons Applying for Admissions; Transit Without
Visa (TWOV) and International-to-International Agreements
FORMS: NONE
OMB NO: 1653-0018 EXPIRATION DATE: 10/31/2005
RESPS:75,000 HOURS:24,975 COSTS(000):$0
Sworn Statement of Refugee Applying for Admission to the United
States
FORMS: G-646
OMB NO: 1653-0026 EXPIRATION DATE: 07/31/2005
RESPS:100 HOURS:100 COSTS(000):$0
Data Relalting to Beneficiary of Private Bill
FORMS: G-79A
OMB NO: 1653-0027 EXPIRATION DATE: 08/31/2005
RESPS:34,500 HOURS:41,938 COSTS(000):$3,787
Application for T nonimmigrant Status; Application for Immediate
Family Member of T-1 Recipient; & Declaration of Law Enforcement
Officer for Victim of Trafficking in Persons
FORMS: I-914 I-914-SUPP-A I-914-SUPP-B
OMB NO: 1653-0028 EXPIRATION DATE: 03/31/2005
RESPS:2,500 HOURS:625 COSTS(000):$0
Request for the Return of Original Document(s)
FORMS: G-884
OMB NO: 1653-0033 EXPIRATION DATE: 11/30/2003
RESPS:5,000 HOURS:7,915 COSTS(000):$0
Memorandum of Understanding to Participate in Employment
Eligibility Confirmation Pilot Program
FORMS: NONE
OMB NO: 1660-0003 EXPIRATION DATE: 10/31/2005
RESPS:9,844 HOURS:11,283 COSTS(000):$5,977
National Flood Insurance Program Biennial Report
FORMS: FEMA-81-28 FEMA-81-29 FEMA-81-29A
OMB NO: 1660-0004 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:400 COSTS(000):$0
Application for Participation in the National Flood Insurance
Program
FORMS: 81-64
OMB NO: 1660-0005 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: 1660-0006 EXPIRATION DATE: 05/31/2003
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: 1660-0007 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: 1660-0008 EXPIRATION DATE: 12/31/2005
RESPS:54,695 HOURS:177,756 COSTS(000):$0
Post Construction Elevation Certificate/Floodproofing Certificate
FORMS: 81-31 81-65
OMB NO: 1660-0009 EXPIRATION DATE: 05/31/2003
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: 1660-0012 EXPIRATION DATE: 09/30/2003
RESPS:520 HOURS:86 COSTS(000):$0
Request for Loan Information Verification
FORMS: FEMA-FORM-90-68
OMB NO: 1660-0013 EXPIRATION DATE: 12/31/2005
RESPS:20 HOURS:100 COSTS(000):$0
Exemption of State-Owned Properties Under Self-Insurance Plan
FORMS: NONE
OMB NO: 1660-0014 EXPIRATION DATE: 02/28/2006
RESPS:16 HOURS:24 COSTS(000):$0
Reimbursement for Cost of Fighting Fire on Federal Property
FORMS: NONE
OMB NO: 1660-0015 EXPIRATION DATE: 09/30/2005
RESPS:3,300 HOURS:11,583 COSTS(000):$0
Right to Submit Technical or Scientific Data to Correct Mapping
Deficiencies
FORMS: 81-87 81-87A 81-87B
OMB NO: 1660-0016 EXPIRATION DATE: 09/30/2005
RESPS:1,400 HOURS:19,600 COSTS(000):$0
Consultation with Local Officials to Assure Compliance with
Sections 110 and 206 of the Flood Disaster Protection Act
FORMS: 81-89 81-89A 81-89B 81-89C 81-89D 81-89E
OMB NO: 1660-0017 EXPIRATION DATE: 09/30/2005
RESPS:222,488 HOURS:94,243 COSTS(000):$0
Public Assistance Progress Report and Program Forms
FORMS: 90-49/90-91 90-91A/90-91B 90-91C/90-19D 90-120/90-121
90-123/90-124 90-125/90-126 90-127/90-128
OMB NO: 1660-0018 EXPIRATION DATE: 04/30/2003
RESPS:7,364 HOURS:814 COSTS(000):$0
Individual and Family Grants Program Administration Information
FORMS: 76-27 76-28 76-29 76-32 76-34 76-38
OMB NO: 1660-0019 EXPIRATION DATE: 07/31/2005
RESPS:7 HOURS:7 COSTS(000):$0
Claims of Federal Personnel for Personal Property Damage or Loss
FORMS: NONE
OMB NO: 1660-0020 EXPIRATION DATE: 09/30/2005
RESPS:1,260 HOURS:693 COSTS(000):$0
Write Your Own (WYO) Program
FORMS: NONE
OMB NO: 1660-0021 EXPIRATION DATE: 08/31/2004
RESPS:300 HOURS:300 COSTS(000):$0
National Fire Academy Executive Fire Officer Program Application
Form
FORMS: FORM-95-22
OMB NO: 1660-0022 EXPIRATION DATE: 02/28/2005
RESPS:940 HOURS:9,260 COSTS(000):$0
Community Rating System (CRS) Program - Application Worksheets
and Commentary
FORMS: FIMA-15 FIMA-15A
OMB NO: 1660-0023 EXPIRATION DATE: 11/30/2005
RESPS:5,000 HOURS:12,000 COSTS(000):$0
Effectiveness of a Community's Implementation of the NFIP
Community Assistance Program CAC and CAV Reports
FORMS: 81-69 81-68
OMB NO: 1660-0024 EXPIRATION DATE: 12/31/2005
RESPS:1 HOURS:160 COSTS(000):$0
Federal Assistance for Offsite Radiological Emergency Planning
FORMS: NONE
OMB NO: 1660-0026 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: 1660-0028 EXPIRATION DATE: 08/31/2004
RESPS:10 HOURS:30 COSTS(000):$0
FEMA Contract Clause-Accessibility of Meetings to Persons with
Disabilities
FORMS: NONE
OMB NO: 1660-0029 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: 1660-0030 EXPIRATION DATE: 09/30/2005
RESPS:1,200 HOURS:367 COSTS(000):$3,000
Request for Site Inspection (FEMA Form 90-1); Landowner's
Authorization/Ingress-Egress Agreement (FF 90-31)
FORMS: 90-1 90-31
OMB NO: 1660-0031 EXPIRATION DATE: 11/30/2005
RESPS:25,000 HOURS:6,250 COSTS(000):$0
National Fire Academy Course Evalation Form (Used for Field/Off-
campus and State Weekend Programs)
FORMS: FEMA-95-45
OMB NO: 1660-0032 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: 1660-0036 EXPIRATION DATE: 08/31/2004
RESPS:96,720 HOURS:24,180 COSTS(000):$0
FEMA Response and Recovery Program Evaluation and Customer
Satisfaction Surveys
FORMS: FORM-86-26(MW)
OMB NO: 1660-0037 EXPIRATION DATE: 05/31/2005
RESPS:9,000 HOURS:21,600 COSTS(000):$1,080
Application Form for Single Lot or Structure Amendments to
National Flood Insurance Program Maps
FORMS: 81-92 81-92A
OMB NO: 1660-0038 EXPIRATION DATE: 12/31/2005
RESPS:5 HOURS:35 COSTS(000):$0
Write Your Own (WYO) Company Participation Criteria; New
Applicant
FORMS: NONE
OMB NO: 1660-0039 EXPIRATION DATE: 11/30/2005
RESPS:1,500 HOURS:375 COSTS(000):$0
National Fire Academy Long-term Course Evaluation Forms
FORMS: NONE
OMB NO: 1660-0040 EXPIRATION DATE: 09/30/2005
RESPS:20,000,000 HOURS:5,600,000 COSTS(000):$0
Standard Flood Hazard Determination Form
FORMS: 81-93
OMB NO: 1660-0042 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: 1660-0047 EXPIRATION DATE: 02/29/2004
RESPS:56 HOURS:182 COSTS(000):$0
Request for Federal Assistance Form - How to Process Mission
Assignments in Federal Disaster Operations
FORMS: FORM-90-129
OMB NO: 1660-0051 EXPIRATION DATE: 05/31/2004
RESPS:18,000 HOURS:405,000 COSTS(000):$0
Proof of Loss Form - Cerro Grande Fire Assistance Claims
FORMS: CG-2
OMB NO: 1660-0053 EXPIRATION DATE: 05/31/2004
RESPS:12 HOURS:18,000 COSTS(000):$0
Subrogration Notice and Proff of Loss - Cerro Grande Fire
Assistance Act
FORMS: CG-3
OMB NO: 1660-0054 EXPIRATION DATE: 12/31/2005
RESPS:25,000 HOURS:174,500 COSTS(000):$0
Assistance to Firefighters Grant Program-Grant Application
Supplemental Information
FORMS: FEMA-20-10 FEMA-20-16 FEMA-16A FEMA-16B FEMA-16C FEMA-20-20
OMB NO: 1660-0055 EXPIRATION DATE: 08/31/2003
RESPS:800 HOURS:2,400 COSTS(000):$0
Request for Mitigation Assistance-Cerro Grande Mitigation
Proposal
FORMS: FFCG-4
OMB NO: 1660-0056 EXPIRATION DATE: 02/28/2005
RESPS:400 HOURS:400 COSTS(000):$0
Small Business Notice and Proof of Loss
FORMS: FFCG-8
OMB NO: 1660-0057 EXPIRATION DATE: 08/31/2004
RESPS:555 HOURS:420 COSTS(000):$0
Chemical Stockpile Emergency Preparedness Program (CSEPP)
Program Evaluation and Customer Satisfaction Baseline Survey
FORMS: NONE
OMB NO: 1660-0058 EXPIRATION DATE: 11/30/2004
RESPS:1,029 HOURS:2,168 COSTS(000):$0
Fire Management Assistance Grant Program
FORMS: 90-58 SF-424 90-91 20-10 270
OMB NO: 1660-0059 EXPIRATION DATE: 10/31/2004
RESPS:78,448 HOURS:3,915 COSTS(000):$0
National Flood Insurance Telephone Response Center (TRC) and
Leads Application Program
FORMS: 81-95
OMB NO: 1660-0060 EXPIRATION DATE: 02/28/2005
RESPS:125 HOURS:157 COSTS(000):$0
Review of Local Mitigation Planning Intiatives and Practices
FORMS: NONE
OMB NO: 1660-0061 EXPIRATION DATE: 03/31/2005
RESPS:40,168 HOURS:29,948 COSTS(000):$0
Federal Assistance to Individuals and Households Program
FORMS: NONE
OMB NO: 1660-0062 EXPIRATION DATE: 10/31/2005
RESPS:556 HOURS:160,460 COSTS(000):$0
State/Local/Tribal Hazard Mitigation Plans Under Section 322 of
the Disaster Mitigation Act of 2000
FORMS: NONE
OMB NO: 1660-0064 EXPIRATION DATE: 10/31/2005
RESPS:820 HOURS:215 COSTS(000):$0
Cerro Grande Arbitrator and Cerro Grande Claimant Questionnaries
FORMS: NONE
OMB NO: 1660-0065 EXPIRATION DATE: 08/31/2003
RESPS:1,150 HOURS:288 COSTS(000):$0
National Earthquake Hazards Reduction Program Review of Publica-
tions
FORMS: NONE
OMB NO: 1660-0066 EXPIRATION DATE: 05/31/2003
RESPS:20 HOURS:80 COSTS(000):$0
Citizen Corps Affiliate Programs and Organizations Application
FORMS: NONE
OMB NO: 1660-0067 EXPIRATION DATE: 06/30/2003
RESPS:162 HOURS:1,972 COSTS(000):$0
Fire Suppression Assistance Program
FORMS: SF-424 SF-270 FEMA-90-91 FEMA-20-10
OMB NO: 1660-0068 EXPIRATION DATE: 02/28/2006
RESPS:2,000 HOURS:1,182 COSTS(000):$0
Federal Hotel and Motel Fire Safety Declaration Form
FORMS: NONE
OMB NO: 1660-0069 EXPIRATION DATE: 03/31/2006
RESPS:1,700,000 HOURS:1,757,760 COSTS(000):$38,115
National Fire Incident reporting System (NFIRS) Version 4.1 and
Version 5.0
FORMS: 4.1-NFIRS-1 NFIRS-2 NFIRS-3 NFIRS-4 NFIRS-5 NFIRS-HMI
5.0-NFIRS-FORMS NO.-1-12
OMB NO: 1660-0070 EXPIRATION DATE: 03/31/2006
RESPS:17,000 HOURS:7,083 COSTS(000):$0
National Fire Department Census
FORMS: 75-100
OMB NO: 2501-0009 EXPIRATION DATE: 04/30/2005
RESPS:20,000 HOURS:10,000 COSTS(000):$0
Record of Employee Interview
FORMS: HUD-11
OMB NO: 2501-0014 EXPIRATION DATE: 12/31/2003
RESPS:10,794,339 HOURS:365,858 COSTS(000):$0
Restrictions on Assistance to Noncitizens (FR-2383)
FORMS: NONE
OMB NO: 2501-0017 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:1 COSTS(000):$0
HUD Alternative for SF 424 Forms, Application for Federal
Assistance and Attendent forms
FORMS: HUD-424 HUD-424-B HUD-424-C HUD-424-CB HUD-424-F
OMB NO: 2502-0082 EXPIRATION DATE: 06/30/2004
RESPS:100,073 HOURS:97,175 COSTS(000):$0
Recertification of Family Income and Composition, Section 235(b)
and Statistical Report Section 235(b), (i) and (j)
FORMS: HUD-93101 HUD-93101A
OMB NO: 2502-0086 EXPIRATION DATE: 09/30/2003
RESPS:32,500 HOURS:3,025 COSTS(000):$0
Monthly Report of Excess Income
FORMS: HUD-93104
OMB NO: 2502-0204 EXPIRATION DATE: 10/31/2004
RESPS:2,207,339 HOURS:2,008,457 COSTS(000):$0
Owner's Certification of Compliance with HUD Tenant Eligibility
and Rent Procedures
FORMS: HUD-50059
OMB NO: 2502-0210 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:10 COSTS(000):$0
Certificate of Need for Health Facility and Assurance of
Enforcement of State Standards
FORMS: HUD-2576-HF
OMB NO: 2502-0233 EXPIRATION DATE: 05/31/2003
RESPS:15,232 HOURS:8,032 COSTS(000):$265
Manufactured Home Construction and Safety Standards Program
FORMS: HUD-101 -203 -203-B -301 -302 -303 -304
OMB NO: 2502-0235 EXPIRATION DATE: 08/31/2003
RESPS:12,000 HOURS:3,000 COSTS(000):$0
Reporting Requirements Associated with 24 CFR 203.508b and 24
CFR 235.1001 - Providing Information
FORMS: NONE
OMB NO: 2502-0243 EXPIRATION DATE: 05/31/2005
RESPS:136,435 HOURS:19,579 COSTS(000):$0
Interstate Land Sales Registration and Consumer Notification
FORMS: NONE
OMB NO: 2502-0253 EXPIRATION DATE: 01/31/2005
RESPS:1,383,997 HOURS:245,493 COSTS(000):$0
Manufactured Home Construction and Safety Standards Act
Reporting Requirements
FORMS: NONE
OMB NO: 2502-0306 EXPIRATION DATE: 06/30/2004
RESPS:1,127,580 HOURS:563,765 COSTS(000):$0
Single Family Property Disposition and Acquisition (Conveyance)
or Mortgaged Properties
FORMS: HUD-9516-A 9519 9519-A 9733 9544 9548 9548-A 9548-B 9548-C
OMB NO: 2502-0313 EXPIRATION DATE: 01/31/2005
RESPS:50 HOURS:2,200 COSTS(000):$0
Technical Suitability of Products Program Section 521 of the
National Housing Act
FORMS: HUD-92005
OMB NO: 2502-0314 EXPIRATION DATE: 11/30/2005
RESPS:16 HOURS:1,080 COSTS(000):$0
Loan Servicing of All Three Coinsurance Programs: Section
221(d), Section 223(f), and Section 232
FORMS: HUD-9815
OMB NO: 2502-0328 EXPIRATION DATE: 04/30/2003
RESPS:330,370 HOURS:95,125 COSTS(000):$0
Title I Property Improvement and Manufactured Home Loan -- 24
CFR 201
FORMS: HUD-637 HUD-27029 HUD-27030 HUD-55013 HUD-55014 HUD-56001
HUD-56001MH HUD-56002 HUD-56002MH HUD-56004/92802
OMB NO: 2502-0340 EXPIRATION DATE: 09/30/2005
RESPS:1,220 HOURS:610 COSTS(000):$0
Single Family Mortgage Insurance on Indian Reservations and
Other Restricted Lands
FORMS: NONE
OMB NO: 2502-0342 EXPIRATION DATE: 07/31/2004
RESPS:123,602 HOURS:28,671 COSTS(000):$0
Pet Ownership in Assisted Rental Housing for the Elderly or
Handicapped
FORMS: NONE
OMB NO: 2502-0349 EXPIRATION DATE: 06/30/2003
RESPS:280 HOURS:140 COSTS(000):$0
Certified Eligibility for Adjustments for Damage or Neglect
FORMS: NONE
OMB NO: 2502-0404 EXPIRATION DATE: 08/31/2005
RESPS:1,000,000 HOURS:250,000 COSTS(000):$0
Requirements for Single Family Mortgage Instruments
FORMS: NONE
OMB NO: 2502-0412 EXPIRATION DATE: 01/31/2004
RESPS:300 HOURS:600 COSTS(000):$0
Lease and Sale of HUD-Acquired Single Family Properties for the
Homeless
FORMS: NONE
OMB NO: 2502-0470 EXPIRATION DATE: 01/31/2006
RESPS:2,290 HOURS:3,485 COSTS(000):$0
Capital Advance Program Submission Requirements for Section 202
Housing for the Elderly and Section 811 Housing for Persons with
Disabilities
FORMS: HUD-90163-CA 90164-CA 90165-CA 90166-CA 90167-CA 90170-CA
90171-CA 90176-CA 90177-CA 91732-CA
OMB NO: 2502-0507 EXPIRATION DATE: 03/31/2005
RESPS:6,000 HOURS:9,000 COSTS(000):$0
AAF Rent Increase Requirement Pursuant to the Housing
Appropriations Act of 1994
FORMS: HUD-92273-S8
OMB NO: 2502-0512 EXPIRATION DATE: 12/31/2004
RESPS:750 HOURS:188 COSTS(000):$3
Automated Cleaning House (ACH) Program Application - Title I
Insurance Charge Payments System
FORMS: HUD-56150
OMB NO: 2502-0514 EXPIRATION DATE: 01/31/2006
RESPS:87 HOURS:5,632 COSTS(000):$87
The Federal National Mortgage Association (Fannie Mae) and the
Federal Home Loan Mortgage Corporation (Freddie Mac) Regulations
FORMS: NONE
OMB NO: 2502-0525 EXPIRATION DATE: 10/31/2005
RESPS:54,000 HOURS:8,964 COSTS(000):$0
Builder's Certification/Guaranee and New Construction
Subterranean Termit Soil Treatment Record
FORMS: HUD-NPCA-99-A HUD-NPCA-99-B
OMB NO: 2502-0526 EXPIRATION DATE: 08/31/2004
RESPS:20 HOURS:400 COSTS(000):$0
Use of Materials Bulletins for the HUD Building Products
Standards and Certification Program
FORMS: NONE
OMB NO: 2502-0542 EXPIRATION DATE: 08/31/2003
RESPS:260 HOURS:4,300 COSTS(000):$0
Assisted Living Conversion Program (ALCP)
FORMS: HUD-92045
OMB NO: 2502-0545 EXPIRATION DATE: 10/31/2004
RESPS:15 HOURS:1,200 COSTS(000):$0
Review of Health Care Facility Portfolios
FORMS: NONE
OMB NO: 2502-0546 EXPIRATION DATE: 06/30/2004
RESPS:4,000 HOURS:2,000 COSTS(000):$0
Home Equity Conversion Mortgage (HECM) Program; Insurance for
Mortgages to Refinance Existing HECMs (FR-4667)
FORMS: NONE
OMB NO: 2502-0547 EXPIRATION DATE: 12/31/2003
RESPS:750,000 HOURS:27,500 COSTS(000):$0
Owner of Record and Re-Sale Data to Preclude Predatory Lending
Practices (Property Flipping) on FHA Insured Mortgages
FORMS: NONE
OMB NO: 2506-0077 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:434,040 COSTS(000):$0
24 CFR Part 570 - Community Development Block Grant Entitlement
Program
FORMS: NONE
OMB NO: 2506-0121 EXPIRATION DATE: 04/30/2005
RESPS:80,000 HOURS:260,000 COSTS(000):$0
Relocation and Real Property Acquisition, Recordkeeping
Requirements Under the Uniform Relocation Assistance and Real
Property Acquisition Policies Act of 1979
FORMS: NONE
OMB NO: 2506-0122 EXPIRATION DATE: 02/29/2004
RESPS:1,115 HOURS:42,700 COSTS(000):$0
Historically Black Colleges and Universities (HBCUs)
FORMS: HUD-40076HBCU
OMB NO: 2506-0128 EXPIRATION DATE: 08/31/2003
RESPS:2,528 HOURS:15,490 COSTS(000):$0
HOPE for Homeownership of Single Family Homes Program (HOPE 3)
FORMS: HUD-40086-B 40102-B 40103 40104 40105
OMB NO: 2506-0133 EXPIRATION DATE: 11/30/2003
RESPS:410 HOURS:28,635 COSTS(000):$0
Housing Opportunities for Persons with AIDS (HOPWA) Program:
Aplication for competitive grants award; annual progress report
for competitive
FORMS: HUD-40110-B HUD-40110-C
OMB NO: 2506-0153 EXPIRATION DATE: 08/31/2004
RESPS:100 HOURS:8,160 COSTS(000):$0
Economic Development Initiative (EDI) & Brownfields Economic
Development Initiative (BEDI) Grant Programs
FORMS: HUD-40076
OMB NO: 2506-0159 EXPIRATION DATE: 03/31/2005
RESPS:800 HOURS:10,200 COSTS(000):$0
Loan Guarantee Recovery Fund Established Pursuant to the Church
Arson Prevention Act of 1996
FORMS: SF-424 HUD-40076-LGA
OMB NO: 2506-0165 EXPIRATION DATE: 07/31/2004
RESPS:580 HOURS:18,560 COSTS(000):$52
Disaster Recovery Grant Reporting System
FORMS: NONE
OMB NO: 2506-0166 EXPIRATION DATE: 11/30/2004
RESPS:3,688 HOURS:23,264 COSTS(000):$0
Technical Assistance for Community Planning and Development
Programs
FORMS: SF-424 SF-424B SF-LLL HUD-424M HUD-50070 HUD-50071 HUD-2880
HUD-2992
OMB NO: 2506-0169 EXPIRATION DATE: 11/30/2003
RESPS:1,240 HOURS:18,940 COSTS(000):$0
Rural Housing and Economic Development Program
FORMS: SF-424
OMB NO: 2506-0170 EXPIRATION DATE: 10/31/2005
RESPS:58 HOURS:3,545 COSTS(000):$0
CDBG Urban County/New York Towns Qualification/Requalification
Process
FORMS: NONE
OMB NO: 2506-0171 EXPIRATION DATE: 03/31/2005
RESPS:245,539 HOURS:379,941 COSTS(000):$0
HOME Investment Partnerships Program
FORMS: HUD-40093 HUD-40093A HUD-40107 HUD-40107-A
OMB NO: 2506-0173 EXPIRATION DATE: 12/31/2004
RESPS:94 HOURS:9,360 COSTS(000):$0
Designation of Round III Empowerment Zones and Renewal
Communities
FORMS: HUD-40005
OMB NO: 2510-0008 EXPIRATION DATE: 11/30/2004
RESPS:213 HOURS:213 COSTS(000):$0
Information request to owners of HUD-assisted multifamily
housing in Boston, pursuant to Section III.A of Consent Decree
in N.A.A.C.P., Boston Chapter v. Martinez
FORMS: HUD-23002
OMB NO: 2510-0011 EXPIRATION DATE: 06/30/2003
RESPS:16,900 HOURS:40,560 COSTS(000):$0
Accountability in the Provision of HUD Assistance
Applicant/Recipient Disclosure/Update
FORMS: HUD-2880
OMB NO: 2528-0170 EXPIRATION DATE: 02/29/2004
RESPS:187,000 HOURS:41,385 COSTS(000):$0
Customer-Survey of Households Living in Federally Assisted Units
FORMS: NONE
OMB NO: 2528-0175 EXPIRATION DATE: 10/31/2003
RESPS:180 HOURS:3,150 COSTS(000):$0
Community Development Work Study Program
FORMS: HUD-424 HUD-424B HUD-2880 HUD-2993 HUD-2994 HUD-3007 HUD-30013
HUD-30014 HUD-30015
OMB NO: 2528-0180 EXPIRATION DATE: 04/30/2003
RESPS:160 HOURS:14,208 COSTS(000):$0
Community Outreach Partnership Centers Program (COPC)
FORMS: HUD-30001 HUD-30002 HUD-30003
OMB NO: 2528-0216 EXPIRATION DATE: 04/30/2004
RESPS:125 HOURS:2,710 COSTS(000):$0
Early Doctoral Student Grant Program
FORMS: NONE
OMB NO: 2528-0217 EXPIRATION DATE: 10/31/2004
RESPS:1,595 HOURS:661 COSTS(000):$0
An Assessment of Third-Party Economic Development Loans Funded
Through HUD's Community Planning and Development Programs
FORMS: NONE
OMB NO: 2528-0218 EXPIRATION DATE: 10/31/2004
RESPS:10,277 HOURS:13,933 COSTS(000):$0
Data Collection for The Interim Impact Evaluation for the Moving
to Opportunity Demonstration
FORMS: NONE
OMB NO: 2528-0219 EXPIRATION DATE: 01/31/2005
RESPS:200 HOURS:400 COSTS(000):$0
Information collection to establish the needs for and uses of
electronic permitting systems in use in building code offices in
communities
FORMS: NONE
OMB NO: 2528-0222 EXPIRATION DATE: 08/31/2005
RESPS:595 HOURS:595 COSTS(000):$0
Mail Survey of HOME Investment Partnership Program Administrators
FORMS: NONE
OMB NO: 2528-0225 EXPIRATION DATE: 05/31/2003
RESPS:45 HOURS:101 COSTS(000):$0
Survey to Determine the Utility of Proposed RESPA Good Faith
Estimate and Guaranteed Mortgage Package Agreement
FORMS: NONE
OMB NO: 2528-0227 EXPIRATION DATE: 08/31/2003
RESPS:80 HOURS:1,700 COSTS(000):$0
Notice of Funding Availability for Research on Socioeconomic
Change in Cities
FORMS: HUD-424 HUD-424-B HUD-424-CB CBW STND.FORM-LLL HUD-2880 HUD-2993
HUD-2994 HUD-2993
OMB NO: 2529-0011 EXPIRATION DATE: 09/30/2004
RESPS:10,750 HOURS:7,148 COSTS(000):$0
Housing Discrimination Information Form 903.1 and the Housing
Discrimination Form HUD-903 (English) and HUD-903A (Spanish)
FORMS: HUD-903 HUD-903A
OMB NO: 2539-0008 EXPIRATION DATE: 01/31/2004
RESPS:520 HOURS:6,240 COSTS(000):$0
Lead-Based Paint Hazard Control Grant Program Data Collection
FORMS: HUD-96006
OMB NO: 2539-0009 EXPIRATION DATE: 12/31/2005
RESPS:2,355,621 HOURS:253,742 COSTS(000):$3,593
Requirements for Lead-Based Paint Hazards in Federally Owned
Resisential Properties and Housing Receiving Federal Assistance
FORMS: NONE
OMB NO: 2539-0010 EXPIRATION DATE: 06/30/2003
RESPS:50 HOURS:2,136 COSTS(000):$0
Notice of Funding Availability / Improving the Evaluation and
Control of Residential Lead-Based Hazards
FORMS: NONE
OMB NO: 2539-0015 EXPIRATION DATE: 01/31/2004
RESPS:290 HOURS:19,040 COSTS(000):$0
Notice of Funding Availability Lead-Based Hazard Control,
Healthy Homes Demonstration, Operation Lead Elimination Action
Program, and Healthy Homes and Lead Technical Studies Grant
Program
FORMS: HUD-424 HUD-424B HUD-424C HUD-2880 HUD-50070 HUD-50071 SF-LLL
OMB NO: 2539-0017 EXPIRATION DATE: 05/31/2003
RESPS:3 HOURS:425 COSTS(000):$0
A Study of the Effectiveness of the Milwaukee Lead Hazard
Control Ordinance
FORMS: NONE
OMB NO: 2539-0018 EXPIRATION DATE: 06/30/2003
RESPS:365 HOURS:43 COSTS(000):$0
Evaluation of Environmental Interventions Conducted under HUD
Lead-Based Paint Abatement Program
FORMS: NONE
OMB NO: 2539-0019 EXPIRATION DATE: 06/30/2004
RESPS:150 HOURS:700 COSTS(000):$0
First National Survey of Environmental Hazards in Child Care
Centers
FORMS: NONE
OMB NO: 2577-0015 EXPIRATION DATE: 09/30/2005
RESPS:2,630 HOURS:8,548 COSTS(000):$0
Contract for Development of A/E Services.
FORMS: HUD-51915 HUD-51915-A
OMB NO: 2577-0021 EXPIRATION DATE: 06/30/2004
RESPS:147 HOURS:147 COSTS(000):$0
Consolidated Public Housing Certificate of Completion
FORMS: NONE
OMB NO: 2577-0024 EXPIRATION DATE: 11/30/2003
RESPS:238 HOURS:1,428 COSTS(000):$0
Life-Cycle Cost Analysis of Utility Combination in Public Housing
FORMS: HUD-51994
OMB NO: 2577-0025 EXPIRATION DATE: 09/30/2004
RESPS:10,150 HOURS:20,155 COSTS(000):$0
Periodical Estimate for Partial Payment and Related Schedules
FORMS: HUD-51001 HUD-51002 HUD-51003 HUD-51004
OMB NO: 2577-0027 EXPIRATION DATE: 05/31/2003
RESPS:3,792 HOURS:720 COSTS(000):$0
Public Housing Construction Report
FORMS: HUD-5378
OMB NO: 2577-0029 EXPIRATION DATE: 10/31/2004
RESPS:22,400 HOURS:16,038 COSTS(000):$0
Allocation of Operating Subsidies Under the Operating Fund
Formula: Data Collection (formerly the Performance Funding
System (PFS)).
FORMS: HUD-52720-A HUD-52720-B HUD-52720-C HUD-52721 HUD-52722-A
HUD-52722-B HUD-52723 HUD-53087
OMB NO: 2577-0033 EXPIRATION DATE: 06/30/2004
RESPS:334 HOURS:7,595 COSTS(000):$0
Public Housing Development and Mixed-Finance Development of
Units; Proposal, Financial Feasibility, Site Information Turnkey
Method, Evidentiary Materials
FORMS: HUD-51971-I HUD-51971-II HUD-52482 HUD-52483-A HUD-52485
HUD-52651-A
OMB NO: 2577-0036 EXPIRATION DATE: 05/31/2004
RESPS:2,435 HOURS:11,667 COSTS(000):$0
Public Housing Agency (PHA) Development cost Budget/Cost
Statement, Actual Development Cost Certification, Acquisition
and Relocation Report
FORMS: HUD-52427 HUD-52484
OMB NO: 2577-0037 EXPIRATION DATE: 08/31/2004
RESPS:110 HOURS:248 COSTS(000):$0
Analysis of Proposed Main Construction Contract
FORMS: HUD-52396
OMB NO: 2577-0039 EXPIRATION DATE: 03/31/2004
RESPS:11,608 HOURS:14,506 COSTS(000):$0
Contract Administration - Public and Indian Housing
FORMS: HUD-5372 HUD-5100
OMB NO: 2577-0044 EXPIRATION DATE: 04/30/2004
RESPS:1,000 HOURS:10,000 COSTS(000):$0
Comprehensive Improvement Assistance Program (CIAP)
Budget/Progress Report and Actual Modernization Cost Certificate
FORMS: HUD-52825 HUD-53001
OMB NO: 2577-0046 EXPIRATION DATE: 10/31/2004
RESPS:12,000 HOURS:12,000 COSTS(000):$0
Procedure for Obtaining Certificates of Insurance for Capital
Program Projects
FORMS: NONE
OMB NO: 2577-0066 EXPIRATION DATE: 09/30/2004
RESPS:3,100 HOURS:6,200 COSTS(000):$0
Housing Agency (HA) Calculation of Occupancy Percentage for
Requested Budget Year (RBY) PHA-Owned Rental Housing,
Performance Funding System (PFS)
FORMS: HUD-52728
OMB NO: 2577-0078 EXPIRATION DATE: 10/31/2004
RESPS:32,000 HOURS:256 COSTS(000):$0
Pet Ownership in Public Housing for the Elderly or Persons with
Disabilities
FORMS: NONE
OMB NO: 2577-0094 EXPIRATION DATE: 11/30/2003
RESPS:2,694 HOURS:2,694 COSTS(000):$0
General Conditions of the Contract for Construction - Public
Housing Programs
FORMS: HUD-5370
OMB NO: 2577-0133 EXPIRATION DATE: 02/29/2004
RESPS:1,500 HOURS:30,000 COSTS(000):$0
Public and Indian Housing Drug Elimination Technical Assistance
Program (DETAP) Consultant Services - Application Kit
FORMS: HUD-52354
OMB NO: 2577-0161 EXPIRATION DATE: 08/31/2003
RESPS:1 HOURS:8,500 COSTS(000):$0
Public Housing-Contracting with Resident-Owned Businesses
Application Requirements
FORMS: NONE
OMB NO: 2577-0166 EXPIRATION DATE: 02/29/2004
RESPS:116,864 HOURS:17,540 COSTS(000):$0
Public and Indian Housing-LOCCS/VRS Payment Vouchers
FORMS: HUD-50080SERIES
OMB NO: 2577-0191 EXPIRATION DATE: 05/31/2003
RESPS:1 HOURS:12,800 COSTS(000):$0
Application for Indian Community Development Block Grant (ICDBG)
Program
FORMS: HUD-4121 HUD-4122 HUD-4123 HUD-4125 HUD-4126
OMB NO: 2577-0192 EXPIRATION DATE: 06/30/2004
RESPS:176 HOURS:3,358 COSTS(000):$0
Requirements for Designating Housing Projects Plan
FORMS: NONE
OMB NO: 2577-0200 EXPIRATION DATE: 06/30/2005
RESPS:250 HOURS:46 COSTS(000):$0
Loan Guarantees for Indian Housing
FORMS: HUD-53036 HUD-53038
OMB NO: 2577-0201 EXPIRATION DATE: 01/31/2005
RESPS:73 HOURS:5,421 COSTS(000):$0
Section 5(h) Homeownership Program for Public Housing:
Submission of Plan and Reporting
FORMS: NONE
OMB NO: 2577-0230 EXPIRATION DATE: 04/30/2003
RESPS:3,400 HOURS:169,300 COSTS(000):$0
Public Housing Reform; Change in Admission and Occupancy
Requirements
FORMS: NONE
OMB NO: 2577-0232 EXPIRATION DATE: 03/31/2006
RESPS:4,500 HOURS:10,850 COSTS(000):$0
Screening and Eviction for Drug Abuse and other Criminal
Activity-Final Rule
FORMS: NONE
OMB NO: 2577-0233 EXPIRATION DATE: 06/30/2003
RESPS:1,000 HOURS:9,720 COSTS(000):$0
Public Housing Homeownership Program Family Application,
Reporting and Recordkeeping Requirements, Homeownership Program
Application and Approval
FORMS: NONE
OMB NO: 2577-0237 EXPIRATION DATE: 08/31/2004
RESPS:939 HOURS:34,026 COSTS(000):$0
Public Housing Assessment System (PHAS) Memorandum of Agreement
(MOA) and Improvement Plan (IP)
FORMS: NONE
OMB NO: 2577-0238 EXPIRATION DATE: 12/31/2004
RESPS:365 HOURS:820 COSTS(000):$7,500
Revision to Cost Limits for Native American Housing
FORMS: NONE
OMB NO: 1004-0001 EXPIRATION DATE: 01/31/2004
RESPS:450 HOURS:215 COSTS(000):$0
Free Use Application and Permit - Vegetative or Mineral Material
(as required by 43 CFR 3620, 5510)
FORMS: FORM-5510-1
OMB NO: 1004-0009 EXPIRATION DATE: 10/31/2004
RESPS:641 HOURS:3,140 COSTS(000):$312
Land Use Application and Permit (43 CFR 2920)
FORMS: 2920-1
OMB NO: 1004-0010 EXPIRATION DATE: 08/31/2003
RESPS:20 HOURS:20 COSTS(000):$0
Conveyances Affecting Color or Claim of title
FORMS: FORM-2540-2
OMB NO: 1004-0011 EXPIRATION DATE: 08/31/2003
RESPS:20 HOURS:20 COSTS(000):$0
Color-of-Title Tax Levy and Payment Record
FORMS: FORM-2540-3
OMB NO: 1004-0012 EXPIRATION DATE: 08/31/2003
RESPS:25 HOURS:1,000 COSTS(000):$3
Application for Land for Recreation and Public Purposes
FORMS: FORM-2740-1
OMB NO: 1004-0074 EXPIRATION DATE: 07/31/2003
RESPS:443 HOURS:886 COSTS(000):$0
Oil and Gas and Geothemal Resources Leasing
FORMS: 3000-2 3200-9
OMB NO: 1004-0103 EXPIRATION DATE: 02/28/2005
RESPS:4,400 HOURS:2,200 COSTS(000):$0
Mineral Materials Disposal (43 CFR 3600, 3601, and 3602)
FORMS: 3600-9
OMB NO: 1004-0109 EXPIRATION DATE: 06/30/2003
RESPS:50 HOURS:1,000 COSTS(000):$0
Payments in Lieu of Taxes (43 CFR 1881)
FORMS: 1004-0109
OMB NO: 1004-0114 EXPIRATION DATE: 11/30/2003
RESPS:236,852 HOURS:31,585 COSTS(000):$368
Recordation of Location Notices and Annual for Mining Claims,
Mill Sites, and Tunnel Sites; Payment of Location and Maintenace
Fees and Service Charges (43 CFR 3730, 3810, 3830, and 3850
FORMS: 3830-2 3830-3
OMB NO: 1004-0119 EXPIRATION DATE: 05/31/2004
RESPS:31,000 HOURS:15,500 COSTS(000):$0
Special Recreation Application and Permit (43 CFR 8370)
FORMS: 8370-1
OMB NO: 1004-0121 EXPIRATION DATE: 06/30/2003
RESPS:276 HOURS:3,760 COSTS(000):$3
Leasing of Solid Minerals Other Than Coal and Oil Shale: 43 CFR
Part 3500 through 3590
FORMS: 3510-1 3520-7 3510-2 3504-1 3504-3 3504-4
OMB NO: 1004-0134 EXPIRATION DATE: 01/31/2004
RESPS:193,855 HOURS:96,885 COSTS(000):$0
Onshore Oil and Gas Operations Nonform Items (as required by 43
CFR 3160)
FORMS: NONE
OMB NO: 1004-0135 EXPIRATION DATE: 01/31/2004
RESPS:34,000 HOURS:14,166 COSTS(000):$0
Sundry Notices and Reports on Wells (as required by 43 CFR 3162)
FORMS: 3160-5
OMB NO: 1004-0136 EXPIRATION DATE: 01/31/2004
RESPS:4,000 HOURS:2,250 COSTS(000):$0
Application for Permit to Drill (as required by 43 CFR 3162)
FORMS: 3160-3
OMB NO: 1004-0137 EXPIRATION DATE: 01/31/2004
RESPS:2,200 HOURS:2,290 COSTS(000):$0
Well Completion or Recompletion Report and Log (as required by
43 CFR Part 3160)
FORMS: 3160-4
OMB NO: 1004-0145 EXPIRATION DATE: 11/30/2005
RESPS:1,770 HOURS:2,235 COSTS(000):$0
Oil and Gas Exploration and Leasing (43 CFR 3100, 3120, and 3150
FORMS: 3100-11
OMB NO: 1004-0153 EXPIRATION DATE: 11/30/2005
RESPS:30 HOURS:300 COSTS(000):$2
43 CFR Part 2720, Conveyance of Federally-Owned Mineral Interests
FORMS: NONE
OMB NO: 1004-0180 EXPIRATION DATE: 08/31/2004
RESPS:200 HOURS:50 COSTS(000):$0
Gas Well Data Survey of Helium-Bearing Natural Gas (PL 104-273)
FORMS: 3100-12
OMB NO: 1004-0184 EXPIRATION DATE: 04/30/2005
RESPS:22,945 HOURS:9,441 COSTS(000):$0
Onshore Oil and Gas Leasing and Operations (43 CFR Part 3100 et
al.)
FORMS: NONE
OMB NO: 1004-0187 EXPIRATION DATE: 12/31/2005
RESPS:5,000 HOURS:83 COSTS(000):$0
Social Security Number/Taxpayer Identification Number (SSN/TIN)
Request
FORMS: 1372-6
OMB NO: 1004-0188 EXPIRATION DATE: 11/30/2003
RESPS:5,066 HOURS:126,650 COSTS(000):$1,862
Rights-of-Way, Federal Land Policy and Management Act of 1976,
and Rights-of-Way, Mineral Leasing Act of 1920 (43 CFR 2800 and
2880).
FORMS: NONE
OMB NO: 1004-0189 EXPIRATION DATE: 10/31/2005
RESPS:5,066 HOURS:126,650 COSTS(000):$1,862
Application for Transportation and Utility Systems and
Facilities on Federal Lands, Standard Form 299.
FORMS: NONE
OMB NO: 1004-0192 EXPIRATION DATE: 06/30/2003
RESPS:1,760 HOURS:440 COSTS(000):$0
Trans-Alaska Pipeline System Survey of the Employee Concerns
Program
FORMS: NONE
OMB NO: 1004-0193 EXPIRATION DATE: 08/31/2003
RESPS:1,720 HOURS:430 COSTS(000):$0
Generic Clearance for Customer Surveys for Stakeholders/Partners
and State and Local Government
FORMS: NONE
OMB NO: 1004-0194 EXPIRATION DATE: 11/30/2003
RESPS:1,897 HOURS:306,536 COSTS(000):$0
Surface Management Activities Under the General Mining Law, 43
CFR Subpart 3809
FORMS: 3809-1 3809-2 3809-4
OMB NO: 1004-0195 EXPIRATION DATE: 02/29/2004
RESPS:540 HOURS:240 COSTS(000):$0
Program Evaluation for the National Riparian Management Service
Team (NRST) and the extended riparian network
FORMS: NONE
OMB NO: 1004-0196 EXPIRATION DATE: 12/31/2004
RESPS:35 HOURS:410 COSTS(000):$0
Oil and Gas Leasing: National Petroleum Reserve, Alaska (NPRA)
(43 CFR 3130, 3133, 3135, 3137, 3138, 3160)
FORMS: NONE
OMB NO: 1006-0001 EXPIRATION DATE: 02/28/2006
RESPS:25,225 HOURS:8,050 COSTS(000):$0
Crop Acreage and Yields and Water Distribution
FORMS: 7-332 7-2045
OMB NO: 1006-0002 EXPIRATION DATE: 04/30/2003
RESPS:535 HOURS:1,070 COSTS(000):$0
Recreation Use Data Report
FORMS: 7-2534-PART1 7-2535-PART2
OMB NO: 1006-0005 EXPIRATION DATE: 12/31/2003
RESPS:19,586 HOURS:14,829 COSTS(000):$0
Individual Landholder's Certification and Reporting Forms for
Acreage Limitation, 43 CFR Part 426 and 43 CFR Part 428
FORMS: 7-21INFO 7-2180 7-2180EZ 7-2181 7-2184 7-2190 7-2190EZ 7-2191
7-2194 7-21PE
OMB NO: 1006-0006 EXPIRATION DATE: 12/31/2003
RESPS:345 HOURS:13,800 COSTS(000):$235
Certification Summary Form, Reporting Summary Form for Acreage
Limitation, 43 CFR Part 426 and 43 CFR Part 428
FORMS: 7-21SUMM-C 7-21SUMM-R
OMB NO: 1006-0014 EXPIRATION DATE: 01/31/2006
RESPS:1,000 HOURS:500 COSTS(000):$0
Lower Colorado River Well Inventory
FORMS: NONE
OMB NO: 1006-0015 EXPIRATION DATE: 08/31/2003
RESPS:54 HOURS:290 COSTS(000):$0
Diversions, Return Flows, and Consumptive Use of Colorado River
Water in the Lower Colorado River Basin
FORMS: LC-72 LC-72A LC-72B
OMB NO: 1006-0023 EXPIRATION DATE: 12/31/2003
RESPS:1,105 HOURS:92 COSTS(000):$0
Limited Recipient Identification Sheet and Trust Information
Sheet for Acreage Limitation, 43 CFR Part 426
FORMS: 7-2536 7-2537
OMB NO: 1006-0024 EXPIRATION DATE: 12/31/2005
RESPS:44 HOURS:44 COSTS(000):$0
Summary of Water Requirements for Crops Grown on Eligible Land
FORMS: LS-924
OMB NO: 1010-0006 EXPIRATION DATE: 03/31/2004
RESPS:8,815 HOURS:16,329 COSTS(000):$414
30 CFR Part 256, Leasing of Sulphur or Oil and Gas in the Outer
Continental Shelf (OCS)
FORMS: FORM-MMS-2028 FORM-MMS-2028A
OMB NO: 1010-0017 EXPIRATION DATE: 08/31/2005
RESPS:13,600 HOURS:1,336 COSTS(000):$0
Form MMS-128, Semiannual Well Test Report (SWTR)
FORMS: MMS-128
OMB NO: 1010-0039 EXPIRATION DATE: 08/31/2004
RESPS:1,250 HOURS:1,250 COSTS(000):$0
Form MMS-126, Well Potential Test Report (WPT)
FORMS: MMS-126
OMB NO: 1010-0041 EXPIRATION DATE: 06/30/2003
RESPS:1,949 HOURS:14,189 COSTS(000):$0
30 CFR 250, Subpart K, Oil and Gas Production Rates
FORMS: MMS-140
OMB NO: 1010-0042 EXPIRATION DATE: 04/30/2004
RESPS:17 HOURS:19 COSTS(000):$0
Sale of Federal Royalty Oil, 30 CFR Part 208 (Originally titled
"Application for the Purchase of Royalty Oil"
FORMS: MMS-4070
OMB NO: 1010-0044 EXPIRATION DATE: 10/31/2005
RESPS:1,315 HOURS:3,288 COSTS(000):$0
Form MMS-123, Application for Permit to Drill (APD)
FORMS: MMS-123
OMB NO: 1010-0045 EXPIRATION DATE: 10/31/2005
RESPS:13,570 HOURS:16,963 COSTS(000):$0
Please note NEW title for this form: Form MMS-124, Application
for Permit to Modify
FORMS: MMS-124
OMB NO: 1010-0046 EXPIRATION DATE: 10/31/2005
RESPS:3,230 HOURS:3,230 COSTS(000):$0
Please note NEW Title for this form: Form MMS-125, End of
Operations Report
FORMS: MMS-125
OMB NO: 1010-0048 EXPIRATION DATE: 05/31/2003
RESPS:963 HOURS:8,109 COSTS(000):$0
30 CFR Part 251, Geological and Geophysical (G&G) Explorations
of the OCS
FORMS: MMS-327 MMS-328 MMS-329
OMB NO: 1010-0049 EXPIRATION DATE: 09/30/2003
RESPS:1,016 HOURS:257,470 COSTS(000):$0
30 CFR 250, Subpart B, Exploration and Development and Production
FORMS: MMS-137 MMS-138 MMS-139 MMS-141
OMB NO: 1010-0071 EXPIRATION DATE: 09/30/2003
RESPS:22 HOURS:8,650 COSTS(000):$661
30 CFR Part 203, Relief or Reduction in Royalty Rates
FORMS: NONE
OMB NO: 1010-0072 EXPIRATION DATE: 01/31/2006
RESPS:21 HOURS:108 COSTS(000):$0
30 CFR Part 280, Prospecting for Minerals other than Oil, Gas,
and Sulphur on the OCS
FORMS: 134 135 136
OMB NO: 1010-0073 EXPIRATION DATE: 08/31/2005
RESPS:319 HOURS:3,674 COSTS(000):$0
30 CFR Part 220, Accounting Procedures for Determining Net
Profit Share Payment for Outer Continental Shelf Oil and Gas
Leases (30 CFR 220.010(a); 220.030(a); 220.031(a), (b), (d), (e);
FORMS: NONE
OMB NO: 1010-0091 EXPIRATION DATE: 10/31/2003
RESPS:801 HOURS:42,233 COSTS(000):$0
30 CFR part 254, Oil-Spill Responses Requirements for Facilities
Located Seaward of the Coast Line
FORMS: NONE
OMB NO: 1010-0123 EXPIRATION DATE: 08/31/2005
RESPS:12 HOURS:180 COSTS(000):$0
30 CFR Part 242, Subpart C-Requests from Indian Lessors for MMS
to Issue Orders (Requirements contained in proposed rule RIN
1010-AC80)
FORMS: NONE
OMB NO: 1010-0126 EXPIRATION DATE: 05/31/2003
RESPS:4,320 HOURS:3,720 COSTS(000):$0
Royalty-In-Kind Pilot Program Directed Third-Party
Communications Between Operators and Purchasers of RIK Federal
Oil and Gas Purchase System
FORMS: NONE
OMB NO: 1010-0128 EXPIRATION DATE: 08/31/2003
RESPS:717 HOURS:5,739 COSTS(000):$0
30 CFR 250, Subpart O-Well Control & Production Safety Training
FORMS: NONE
OMB NO: 1010-0129 EXPIRATION DATE: 06/30/2003
RESPS:1,869 HOURS:1,324 COSTS(000):$0
Bids and Financial Statements for Sale of Royalty Oil and Gas
(RIK Pilots)
FORMS: FORM-MMS-4440
OMB NO: 1010-0130 EXPIRATION DATE: 04/30/2003
RESPS:30 HOURS:201 COSTS(000):$0
Directed Communications Between Operators of Federaal RIK Leases
and Deliverers of Equivalent Oil Production to the Strategic
Petroleum Reserve
FORMS: NONE
OMB NO: 1010-0131 EXPIRATION DATE: 10/31/2005
RESPS:1,315 HOURS:1,973 COSTS(000):$0
Form MMS-123S, Supplemental APD Information Sheet
FORMS: MMS-123S
OMB NO: 1010-0132 EXPIRATION DATE: 10/31/2005
RESPS:10,000 HOURS:10,000 COSTS(000):$0
Please note NEW title form: Form MMS-133, Well Activity Report
FORMS: MMS-133
OMB NO: 1010-0135 EXPIRATION DATE: 05/31/2003
RESPS:25 HOURS:25 COSTS(000):$0
Royalty-in-King (RIK) Small Refiner Sale Program
FORMS: MMS-4071 MMS-4072
OMB NO: 1010-0139 EXPIRATION DATE: 07/31/2003
RESPS:360,400 HOURS:89,129 COSTS(000):$1,533
Production Accounting and Auditing System Oil and Gas Reports
FORMS: MMS-4054 MMS-4055 MMS-4056 MMS-4058
OMB NO: 1010-0140 EXPIRATION DATE: 08/31/2003
RESPS:2,496,000 HOURS:133,120 COSTS(000):$4,700
Report of Sales and Royalty Remittance
FORMS: MMS-2014
OMB NO: 1010-0141 EXPIRATION DATE: 01/31/2006
RESPS:12,720 HOURS:111,209 COSTS(000):$0
Note New title for this collection: 30 CFR 250, Subpart D, Oil
and Gas Drilling Operations
FORMS: NONE
OMB NO: 1018-0049 EXPIRATION DATE: 09/30/2003
RESPS:1,456 HOURS:5,250 COSTS(000):$0
Grant agreement and amendment to grant agreement
FORMS: FORM-3-1552 FORM-3-1591
OMB NO: 1018-0097 EXPIRATION DATE: 01/31/2004
RESPS:2,450 HOURS:875 COSTS(000):$0
Depredation Order for Double-crested Cormorant 50 CFR 21.47
FORMS: NONE
OMB NO: 1018-0100 EXPIRATION DATE: 08/31/2005
RESPS:150 HOURS:37,600 COSTS(000):$0
Information Collection In Support of Grant Programs Authorized
by the North American Wetlands Conservation Act (NAWCA)
FORMS: NONE
OMB NO: 1018-0101 EXPIRATION DATE: 03/31/2005
RESPS:135 HOURS:270 COSTS(000):$0
Monitoring Recovered Species After Delisting As Required Under
Section 4(g) of the Endangered Species Act
FORMS: N/A
OMB NO: 1018-0102 EXPIRATION DATE: 11/30/2004
RESPS:10,440 HOURS:10,440 COSTS(000):$0
Special use permit application on National Wildlife Refuges
outside Alaska covering 50 CFR 25.41, 25.61, 30.11, 31.13, and
31.16
FORMS: 3-1383
OMB NO: 1018-0103 EXPIRATION DATE: 03/31/2005
RESPS:24 HOURS:720 COSTS(000):$0
Conservation Order for Control of Mid-Continent Light Geese, 50
CFR 21.60
FORMS: NONE
OMB NO: 1018-0104 EXPIRATION DATE: 11/30/2005
RESPS:40 HOURS:640 COSTS(000):$0
Information Collection in support of programs authorized by the
North American Wetlands Conservation Act (NAWCA) and Council
FORMS: NONE
OMB NO: 1018-0109 EXPIRATION DATE: 01/31/2004
RESPS:5,750 HOURS:323,000 COSTS(000):$0
The Federal Aid Grant Application Booklet 50 CFR 80
FORMS: NONE
OMB NO: 1018-0111 EXPIRATION DATE: 09/30/2004
RESPS:34 HOURS:17 COSTS(000):$0
Summary Information for Ranking National Coastal Wetlands Grant
Program Proposals, 50 CFR 84.
FORMS: FORM-3-2179
OMB NO: 1018-0112 EXPIRATION DATE: 11/30/2004
RESPS:400 HOURS:100 COSTS(000):$0
U.S. Fish & Wildlife Service Employee Exit Follow-up, authorized
by the Merit System Principles (5 U.S.C. 2301)
FORMS: 3-2186
OMB NO: 1018-0113 EXPIRATION DATE: 11/30/2005
RESPS:30 HOURS:1,200 COSTS(000):$0
Information collection in support of grant program authorized by
the Neotropical Migratory Bird Conservation Act (PL 106-247, 114
Stat. 593).
FORMS: NONE
OMB NO: 1018-0115 EXPIRATION DATE: 04/30/2005
RESPS:1,227 HOURS:61 COSTS(000):$0
USFWS Training Records: Application for FWS Training Request
FORMS: FORM-3-2193
OMB NO: 1018-0117 EXPIRATION DATE: 05/31/2005
RESPS:60 HOURS:30 COSTS(000):$0
State Certification of Expenditures, Public Law 106-408
FORMS: 3-2197A
OMB NO: 1024-0021 EXPIRATION DATE: 04/30/2004
RESPS:4,200 HOURS:2,100 COSTS(000):$0
National Capital Region Application for Public Gathering, 36 CFR
7.96(g)
FORMS: NONE
OMB NO: 1024-0022 EXPIRATION DATE: 01/31/2004
RESPS:295,339 HOURS:24,612 COSTS(000):$0
Backcountry Use Permit (36 CFR 1.5, 1.6, and 2.10)
FORMS: 10-404
OMB NO: 1024-0026 EXPIRATION DATE: 09/30/2003
RESPS:18,600 HOURS:11,150 COSTS(000):$930
Special Park Use Applications (36 CFR)
FORMS: NPS-10-939 NPS-10-931 NPS-10-932
OMB NO: 1024-0028 EXPIRATION DATE: 02/29/2004
RESPS:164 HOURS:248 COSTS(000):$0
Urban Park and Recreation Recovery Program Project Performance
Report
FORMS: CONSTR.11/80 NONCONSTR.11/80
OMB NO: 1024-0031 EXPIRATION DATE: 02/29/2004
RESPS:450 HOURS:115 COSTS(000):$0
Land and Water Conservation Fund Description and Notification
Form
FORMS: 10-903
OMB NO: 1024-0032 EXPIRATION DATE: 02/29/2004
RESPS:700 HOURS:700 COSTS(000):$0
Land and Water Conservation Fund Program Performance Report
FORMS: N/A
OMB NO: 1024-0033 EXPIRATION DATE: 02/29/2004
RESPS:450 HOURS:450 COSTS(000):$0
Land and Water Conservation Fund Project Agreement and Amendment
FORMS: 10-902 10-902A
OMB NO: 1024-0034 EXPIRATION DATE: 02/29/2004
RESPS:7,400 HOURS:3,700 COSTS(000):$0
Land and Water Conservation Fund On-Site Inspection Report
FORMS: N/A
OMB NO: 1024-0038 EXPIRATION DATE: 07/31/2004
RESPS:29,500 HOURS:21,508 COSTS(000):$0
Procedures for State, Tribal, and Local Government Historic
Preservation Programs; 36 CFR 61
FORMS: NONE
OMB NO: 1024-0047 EXPIRATION DATE: 02/29/2004
RESPS:50 HOURS:1,750 COSTS(000):$0
Land and Water Conservation Fund Conversion of Use Provisions
FORMS: N/A
OMB NO: 1024-0048 EXPIRATION DATE: 02/29/2004
RESPS:3 HOURS:75 COSTS(000):$0
Urban Park and Recreation Recovery Program Conversion of Use
Provisions
FORMS: N/A
OMB NO: 1024-0064 EXPIRATION DATE: 06/30/2003
RESPS:23 HOURS:4,048 COSTS(000):$0
36 CFR Part 9, Subpart A - Mining and Minimg Claims 36 CFR Part
9, Subpart B - Non-Federal Oil and Gas
FORMS: NONE
OMB NO: 1024-0089 EXPIRATION DATE: 02/29/2004
RESPS:20 HOURS:20 COSTS(000):$0
Urban Park and Recreation Recovery Program Project Agreement and
Amendment
FORMS: FNP10-912 FNP10-915
OMB NO: 1024-0125 EXPIRATION DATE: 08/31/2003
RESPS:240 HOURS:76,800 COSTS(000):$1,120
Submission of Offers in Response to Concession Opportunities
FORMS: NONE
OMB NO: 1024-0126 EXPIRATION DATE: 02/28/2006
RESPS:20 HOURS:1,600 COSTS(000):$5
Proposed Sale of Concession Operations (36 CFR, Part 51,.
Subpart J)
FORMS: NONE
OMB NO: 1024-0224 EXPIRATION DATE: 09/30/2004
RESPS:90,000 HOURS:15,000 COSTS(000):$0
Programmatic Approval for National Park Service-Sponsored Public
Surveys
FORMS: NONE
OMB NO: 1024-0226 EXPIRATION DATE: 07/31/2005
RESPS:790 HOURS:132 COSTS(000):$0
National Park Service Partnership Programs GPRA Information
Collections
FORMS: NONE
OMB NO: 1024-0233 EXPIRATION DATE: 01/31/2004
RESPS:627 HOURS:4,392 COSTS(000):$0
National Park Service leasing Program -- 36 CFR Part 18
FORMS: NONE
OMB NO: 1024-0236 EXPIRATION DATE: 04/30/2004
RESPS:6,000 HOURS:4,875 COSTS(000):$0
Application for a Scientific Research and Collecting Permit:
Investigator's Annual Report; re 36 CFR 2.1 and 2.5
FORMS: 10-741 10-226
OMB NO: 1024-0242 EXPIRATION DATE: 09/30/2004
RESPS:400 HOURS:125 COSTS(000):$0
National Park Service Urban and Adjacent Parks: Assessment and
Development of Community Outreach
FORMS: NONE
OMB NO: 1028-0051 EXPIRATION DATE: 11/30/2003
RESPS:370 HOURS:12,800 COSTS(000):$0
National Earthquake Hazards Reduction Program Annual Announce-
ment of Availability of Funds
FORMS: 424 269 270
OMB NO: 1028-0056 EXPIRATION DATE: 05/31/2004
RESPS:450 HOURS:150 COSTS(000):$0
North American Reporting Center for Amphibian Malformations
FORMS: NONE
OMB NO: 1028-0057 EXPIRATION DATE: 11/30/2003
RESPS:1,000 HOURS:350 COSTS(000):$0
The National Atlas of the United States of America
FORMS: NONE
OMB NO: 1028-0059 EXPIRATION DATE: 02/29/2004
RESPS:3,000 HOURS:750 COSTS(000):$0
Comprehensive Test Ban Treaty
FORMS: 9-4040-A
OMB NO: 1028-0060 EXPIRATION DATE: 12/31/2003
RESPS:739 HOURS:555 COSTS(000):$0
Mine, Development, and Mineral Exploration Supplement
FORMS: 9-4000-A
OMB NO: 1028-0065 EXPIRATION DATE: 02/29/2004
RESPS:3,450 HOURS:742 COSTS(000):$0
Production Estimate, Quarterly Construction Sand and Gravel and
Crushed and Broken Stone
FORMS: 9-4042-A 9-4124-A
OMB NO: 1028-0069 EXPIRATION DATE: 10/31/2004
RESPS:3,000 HOURS:150 COSTS(000):$0
User Survey for National Biological Information Infrastructure
FORMS: NONE
OMB NO: 1028-0074 EXPIRATION DATE: 07/31/2004
RESPS:700 HOURS:292 COSTS(000):$0
Assessment of the Use and Benefits of Waterfowl Production Areas
in Minnesota
FORMS: NONE
OMB NO: 1028-0075 EXPIRATION DATE: 07/31/2004
RESPS:1,000 HOURS:416 COSTS(000):$0
Understanding Visitor Uses, Motives, and Benefits at Sherburne
National Wildlife Refuge
FORMS: NONE
OMB NO: 1028-0076 EXPIRATION DATE: 07/31/2004
RESPS:1,400 HOURS:268 COSTS(000):$0
Conservation Reserve Program (CRP) Contractee Perceptions on
Environmental Benefits and Management
FORMS: NONE
OMB NO: 1028-0077 EXPIRATION DATE: 03/31/2005
RESPS:600 HOURS:150 COSTS(000):$0
Visitor knowledge and economic impact at Arapaho, Arrowwod and
Sand Lake National Wildlife Refuges
FORMS: NONE
OMB NO: 1028-0078 EXPIRATION DATE: 03/31/2005
RESPS:1,000 HOURS:7,000 COSTS(000):$0
North American Amphibian Monitoring Program
FORMS: NONE
OMB NO: 1028-0079 EXPIRATION DATE: 03/31/2005
RESPS:2,500 HOURS:12,500 COSTS(000):$0
North American Breeding Bird Survey
FORMS: NONE
Office of Surface Mining Reclamation and Enforcement
OMB NO: 1029-0024 EXPIRATION DATE: 08/31/2004
RESPS:65 HOURS:9,205 COSTS(000):$0
Procedures and Criteria for Approval or Disapproval of State
Program Submissions, 30 CFR PART 732
FORMS: NONE
OMB NO: 1029-0025 EXPIRATION DATE: 08/31/2003
RESPS:2 HOURS:200 COSTS(000):$0
Maintenance of State programs and procedures for substituting
Federal enforcement of State programs and withdrawing approval
of State programs, 30 CFR 733.
FORMS: NONE
OMB NO: 1029-0027 EXPIRATION DATE: 10/31/2005
RESPS:36 HOURS:2,433 COSTS(000):$0
General Requirements for Surface Coal Mining and Reclamation
Operations on Federal Lands - 30 CFR 740
FORMS: NONE
OMB NO: 1029-0030 EXPIRATION DATE: 07/31/2004
RESPS:4 HOURS:7,240 COSTS(000):$0
State processes for designating areas unsuitable for surface
coal mining operations, 30 CFR Part 764
FORMS: NONE
OMB NO: 1029-0040 EXPIRATION DATE: 08/31/2003
RESPS:347 HOURS:16,372 COSTS(000):$0
30 CFR Part 785 -- Requirements for permits for special
categories of mining
FORMS: NONE
OMB NO: 1029-0043 EXPIRATION DATE: 12/31/2005
RESPS:14,167 HOURS:166,114 COSTS(000):$2,437
30 CFR Part 800 -- Bond and Insurance Requirements for Surface
Coal Mining and Reclamation Operations Under Regulatory Programs
FORMS: NONE
OMB NO: 1029-0049 EXPIRATION DATE: 07/31/2004
RESPS:10 HOURS:1,000 COSTS(000):$0
Special permanent program performance standards-operations in
alluvial valley floors, 30 CFR Part 822
FORMS: NONE
OMB NO: 1029-0051 EXPIRATION DATE: 01/31/2004
RESPS:99,013 HOURS:578,509 COSTS(000):$1
Permanent Program Inspection and Enforcement Procedures, 30 CFR
Part 840.
FORMS: NONE
OMB NO: 1029-0055 EXPIRATION DATE: 05/31/2005
RESPS:20 HOURS:20 COSTS(000):$1
Rights of Entry - Part 877
FORMS: NONE
OMB NO: 1029-0057 EXPIRATION DATE: 03/31/2004
RESPS:1 HOURS:16 COSTS(000):$0
Reclamation on Private Land - 30 CFR 882
FORMS: NONE
OMB NO: 1029-0059 EXPIRATION DATE: 01/31/2006
RESPS:132 HOURS:706 COSTS(000):$0
30 CFR 735 - Grants for Program Development and Administration
and Enforcement, and 30 CFR 886 - State and Tribal Reclamation
Grants
FORMS: 47 49 51
OMB NO: 1029-0061 EXPIRATION DATE: 06/30/2003
RESPS:160 HOURS:10,635 COSTS(000):$0
Small Operator Assistance Program - Part 795
FORMS: FORM-FS-6
OMB NO: 1029-0063 EXPIRATION DATE: 06/30/2003
RESPS:15,804 HOURS:4,280 COSTS(000):$0
Coal Production and Reclamation Fee Report
FORMS: OSM-1
OMB NO: 1029-0067 EXPIRATION DATE: 08/31/2005
RESPS:2,909 HOURS:974 COSTS(000):$0
Statement of Employment and Financial Interests for Use by State
Employees - 30 CFR Part 705
FORMS: OSM-23
OMB NO: 1029-0080 EXPIRATION DATE: 03/31/2004
RESPS:1 HOURS:173 COSTS(000):$0
Permanent regulatory program requirements-standards for
certification of blasters, 30 CFR 850
FORMS: NONE
OMB NO: 1029-0083 EXPIRATION DATE: 08/31/2005
RESPS:33 HOURS:57 COSTS(000):$3
Application for Blaster Certification in Federal Program States
and Indian Lands - 30 CFR Part 955
FORMS: OSM-74
OMB NO: 1029-0087 EXPIRATION DATE: 03/31/2004
RESPS:1,800 HOURS:4,000 COSTS(000):$0
Abandoned Mine Land Problem Area Description Form, OSM 76
FORMS: OSM-76
OMB NO: 1029-0089 EXPIRATION DATE: 03/31/2004
RESPS:61 HOURS:513 COSTS(000):$0
Exemption for Coal Extraction Incidental to the Extraction of
Other Minerals, 30 CFR Part 702
FORMS: NONE
OMB NO: 1029-0094 EXPIRATION DATE: 11/30/2003
RESPS:6 HOURS:12 COSTS(000):$0
General - 30 CFR Part 700
FORMS: NONE
OMB NO: 1029-0098 EXPIRATION DATE: 11/30/2003
RESPS:1 HOURS:120 COSTS(000):$0
Petition process for designation of Federal lands as unsuitable
for all or certain types of surface coal mining operations and
for termination of previous designation - 30 CFR 769
FORMS: NONE
OMB NO: 1029-0115 EXPIRATION DATE: 12/31/2003
RESPS:310 HOURS:11,116 COSTS(000):$12
Requirements for permits and permit processing - 30 CFR Part 773
FORMS: NONE
OMB NO: 1029-0116 EXPIRATION DATE: 12/31/2003
RESPS:12,090 HOURS:97,780 COSTS(000):$0
Revision; Renewal; and Transfer, Assignment, or Sale of Permit
Rights - 30 CFR 774
FORMS: NONE
OMB NO: 1029-0117 EXPIRATION DATE: 12/31/2003
RESPS:310 HOURS:8,437 COSTS(000):$0
Permit Applications - minimum requirements for legal, financial,
compliance, and related information-Part 778
FORMS: NONE
OMB NO: 1029-0118 EXPIRATION DATE: 06/30/2005
RESPS:126 HOURS:95 COSTS(000):$0
Federal inspections and monitoring - 30 CFR Part 842
FORMS: NONE
OMB NO: 1029-0119 EXPIRATION DATE: 11/30/2003
RESPS:519 HOURS:465 COSTS(000):$0
Abandoned Mine Land Contractor Information Form
FORMS: NONE
OMB NO: 1029-0120 EXPIRATION DATE: 01/31/2004
RESPS:1,600 HOURS:134 COSTS(000):$0
Technical Training Program Course Nomination and Payment for
Travel and Per Diem Forms
FORMS: OSM-105 OSM-140
OMB NO: 1076-0062 EXPIRATION DATE: 04/30/2003
RESPS:4,900 HOURS:2,450 COSTS(000):$0
Application for Training or Employment
FORMS: BIA-8205
OMB NO: 1076-0084 EXPIRATION DATE: 10/31/2004
RESPS:3,500 HOURS:1,750 COSTS(000):$0
25 CFR 256 United States Department of the Interior, Burau of
Indian Affairs Housing Improvement Program
FORMS: BIA-6407
OMB NO: 1076-0094 EXPIRATION DATE: 06/30/2005
RESPS:260 HOURS:65 COSTS(000):$0
Title 25 CFR 11, Subpart F, Law & Order on Indian Reservations
FORMS: NONE
OMB NO: 1076-0096 EXPIRATION DATE: 09/30/2005
RESPS:360 HOURS:1,800 COSTS(000):$0
Education Contracts under Johnson O'Malley Act Application and
regulatory Requirements, 25 CFR 273.50
FORMS: BIA-NO-62118
OMB NO: 1076-0100 EXPIRATION DATE: 12/31/2003
RESPS:9,200 HOURS:36,800 COSTS(000):$0
25 CFR 151, Acquisition of Title to Land in Trust
FORMS: NONE
OMB NO: 1076-0104 EXPIRATION DATE: 09/30/2003
RESPS:10 HOURS:22,377 COSTS(000):$0
Documented Petitions for Federal Acknowledgment as an Indian
Tribe, 25 CFR 83
FORMS: 8304 8305 8306
OMB NO: 1076-0111 EXPIRATION DATE: 10/31/2003
RESPS:4 HOURS:12 COSTS(000):$0
25 CFR 23.13, Payment for Appointed Counsel in Involuntary
Indian Child Custody Proceedings in State Courts
FORMS: NONE
OMB NO: 1076-0114 EXPIRATION DATE: 10/31/2005
RESPS:3,943 HOURS:2,214 COSTS(000):$15
Application for Admission to Haskell Indian Nations University
and to Southwestern Indian Polytechnic Institure
FORMS: NONE
OMB NO: 1076-0122 EXPIRATION DATE: 08/31/2005
RESPS:48,000 HOURS:12,000 COSTS(000):$0
Data Elements for Student Enrollment in Bureau - funded Schools
FORMS: NONE
OMB NO: 1076-0146 EXPIRATION DATE: 06/30/2005
RESPS:70 HOURS:1,680 COSTS(000):$0
Evaluation of the performance of trust functions performed by
tribes under self-governance compacts, 25 CFR 1000, Subpart O
FORMS: NONE
OMB NO: 1076-0147 EXPIRATION DATE: 05/31/2005
RESPS:280 HOURS:140 COSTS(000):$0
U.S. Department of the Interior, Bureau of Indian Affairs Indian
Service Population and Labor Force Estimates Report
FORMS: NONE
OMB NO: 1076-0149 EXPIRATION DATE: 04/30/2003
RESPS:12 HOURS:3,840 COSTS(000):$0
Class III Gaming Procedures 25 CFR 522
FORMS: NONE
OMB NO: 1076-0153 EXPIRATION DATE: 06/30/2003
RESPS:287,400 HOURS:433,500 COSTS(000):$0
Request for Certificate of Degree of Indian or Alaska Native
Blood, 25 CFR Part 70
FORMS: NONE
OMB NO: 1076-0154 EXPIRATION DATE: 10/31/2003
RESPS:1,997,500 HOURS:1,577,125 COSTS(000):$0
Funds Held in Trust for Tribes and Individuals 25 CFR-115
FORMS: NONE
OMB NO: 1076-0156 EXPIRATION DATE: 09/30/2003
RESPS:32,589 HOURS:156,407 COSTS(000):$60
Probate of Indian Estates, Except for Members of the Five
Civilized Tribes 25 CFR 15
FORMS: NONE
OMB NO: 1076-0158 EXPIRATION DATE: 11/30/2003
RESPS:2 HOURS:2,000 COSTS(000):$0
Gaming on Trust Lands Acquired After October 17, 1988 25 CFR 292
FORMS: NONE
OMB NO: 1076-0159 EXPIRATION DATE: 03/31/2004
RESPS:1,325 HOURS:68,035 COSTS(000):$0
25 CFR 151, Acquisition of Title to Land in Trust and Tribal
Land Acquisition Area
FORMS: NONE
OMB NO: 1076-0160 EXPIRATION DATE: 05/31/2005
RESPS:5,000 HOURS:2,500 COSTS(000):$6
Verification of Indian Preference for Employment in BIA & IHS
FORMS: BIA-4432
OMB NO: 1085-0001 EXPIRATION DATE: 06/30/2005
RESPS:100 HOURS:25 COSTS(000):$0
Source Directory of American Indian and Alaska Native owned and
operated arts & crafts businesses
FORMS: NONE
OMB NO: 1085-0002 EXPIRATION DATE: 06/30/2005
RESPS:580 HOURS:97 COSTS(000):$0
Non-member Indian Artisan Certification Program - 25 CFR 309
FORMS: NONE
OMB NO: 1091-0001 EXPIRATION DATE: 03/31/2006
RESPS:560,000 HOURS:46,480 COSTS(000):$0
US Department of the Interior, Applicant Background Survey
FORMS: 1935
OMB NO: 1103-0043 EXPIRATION DATE: 10/31/2003
RESPS:128 HOURS:1,472 COSTS(000):$0
Regional Community Policing Institute Quarterly Progress Report
FORMS: 022/01
OMB NO: 1103-0061 EXPIRATION DATE: 02/29/2004
RESPS:23,118 HOURS:11,559 COSTS(000):$0
COPS Grant Status Survey
FORMS: 301/02
OMB NO: 1103-0066 EXPIRATION DATE: 02/29/2004
RESPS:10,000 HOURS:2,500 COSTS(000):$0
National Center for Victims of Crime: Service Referral
Questionnaire
FORMS: COPS/PPSE/02
OMB NO: 1103-0072 EXPIRATION DATE: 01/31/2005
RESPS:200 HOURS:1,800 COSTS(000):$0
Tribal Resources Grant Program Application
FORMS: NONE
OMB NO: 1103-0078 EXPIRATION DATE: 09/30/2005
RESPS:10 HOURS:35 COSTS(000):$0
Mental Health and Community Safety Initiative Equipment and
Training Progress Report
FORMS: NONE
OMB NO: 1103-0079 EXPIRATION DATE: 09/30/2005
RESPS:2,800 HOURS:1,400 COSTS(000):$0
COPS In Schools/Safe Schools Healthy Students Annual Report
FORMS: NONE
OMB NO: 1103-0080 EXPIRATION DATE: 07/31/2005
RESPS:10 HOURS:15 COSTS(000):$0
Mental Health and Community Safety Initiative Hiring Progress
Report
FORMS: NONE
OMB NO: 1103-0084 EXPIRATION DATE: 10/31/2003
RESPS:100 HOURS:1,500 COSTS(000):$0
Methamphetamine Discretionary Grant Program Application
FORMS: NONE
OMB NO: 1103-0085 EXPIRATION DATE: 10/31/2003
RESPS:200 HOURS:1,800 COSTS(000):$0
Community Policing Development Proposal Packet
FORMS: NONE
OMB NO: 1103-0086 EXPIRATION DATE: 10/31/2003
RESPS:200 HOURS:300 COSTS(000):$0
Tribal Resources Grant Program Hiring Progress Report
FORMS: NONE
OMB NO: 1103-0087 EXPIRATION DATE: 10/31/2003
RESPS:200 HOURS:600 COSTS(000):$0
Tribal Resources Grant Program Equipment and Training Progress
Report
FORMS: NONE
OMB NO: 1103-0088 EXPIRATION DATE: 10/31/2003
RESPS:15 HOURS:37 COSTS(000):$0
Tribal Hiring Renewal Grant Program Application
FORMS: NONE
OMB NO: 1105-0025 EXPIRATION DATE: 10/31/2005
RESPS:20 HOURS:40 COSTS(000):$0
Department of Justice Federal Coal Lease Review Information
FORMS: ATR-139 ATR-140
OMB NO: 1105-0030 EXPIRATION DATE: 07/31/2004
RESPS:4,500 HOURS:4,500 COSTS(000):$0
Application Booklets-Attorney General's Honor Program; Summer
Law Intern Program
FORMS: NONE
OMB NO: 1105-0052 EXPIRATION DATE: 07/31/2005
RESPS:3,000 HOURS:7,500 COSTS(000):$0
Claims Under the Radiation Exposure Compensation Act
FORMS: NONE
OMB NO: 1105-0073 EXPIRATION DATE: 09/30/2005
RESPS:5,000 HOURS:30,000 COSTS(000):$0
Registration/Eligibility Form and Application for Emergency
Benefits from the Victim Compensation Fund
FORMS: SM-001
OMB NO: 1105-0074 EXPIRATION DATE: 01/31/2006
RESPS:203,500 HOURS:25,050 COSTS(000):$0
Flight Training Candidate Checks Program
FORMS: FTTTF-1 FTTTF-2
OMB NO: 1105-0077 EXPIRATION DATE: 10/31/2005
RESPS:250 HOURS:500 COSTS(000):$0
Victim Compensation Fund Objection Form
FORMS: SM-002
OMB NO: 1105-0078 EXPIRATION DATE: 10/31/2005
RESPS:5,000 HOURS:75,000 COSTS(000):$500
The Death Compensation form for the September 11 Victim
Compensation Fund and The Personal Injury Compensation Form for
the September 11 Victim Compensation Fund
FORMS: SM-003
OMB NO: 1110-0001 EXPIRATION DATE: 09/30/2003
RESPS:212,004 HOURS:74,201 COSTS(000):$449
Return A-Monthly Return of Offenses known to Police and
Supplement to Return A-Monthly Return of Offenses known to
Police.
FORMS: 4-927A 4-919
OMB NO: 1110-0004 EXPIRATION DATE: 09/30/2005
RESPS:16,825 HOURS:2,243 COSTS(000):$0
Full-Time Law Enforcement Employee as of October 31
FORMS: 1-711 1-711A 1-711B
OMB NO: 1110-0005 EXPIRATION DATE: 10/31/2005
RESPS:403,800 HOURS:201,900 COSTS(000):$0
Age, Sex and Race of person arrested (18 years of age and over)
Age, sex, and Race of person arrested (Under 18 years of age)
FORMS: 1-708 1-708A
OMB NO: 1110-0006 EXPIRATION DATE: 02/29/2004
RESPS:212,004 HOURS:24,734 COSTS(000):$0
Law Enforcement Officers Killed and Assaulted
FORMS: I-750
OMB NO: 1110-0008 EXPIRATION DATE: 09/30/2005
RESPS:201,900 HOURS:30,285 COSTS(000):$0
Monthly Return of Arson Offenses Known to Law Enforcement
FORMS: 1-725
OMB NO: 1110-0009 EXPIRATION DATE: 02/29/2004
RESPS:570 HOURS:570 COSTS(000):$0
Analysis of Law Enforcement Officers Killed And Assaulted
FORMS: I-701
OMB NO: 1110-0036 EXPIRATION DATE: 01/31/2005
RESPS:150,000 HOURS:702,000 COSTS(000):$0
National Stolen Passenger Motor Vehicle Information System
FORMS: NONE
OMB NO: 1115-0238 EXPIRATION DATE: 06/30/2004
RESPS:10 HOURS:40 COSTS(000):$2
Application for Authorization to Issue Health Care Certificates
FORMS: I-905
OMB NO: 1115-0253 EXPIRATION DATE: 08/31/2004
RESPS:1,500 HOURS:1,500 COSTS(000):$273
Application for Citizenship and Issuance of Certificate Under
Section 322
FORMS: N-600K
OMB NO: 1115-0254 EXPIRATION DATE: 04/30/2003
RESPS:140,000 HOURS:70,000 COSTS(000):$0
National Security Entry-Exit Registration System
FORMS: NONE
OMB NO: 1115-0255 EXPIRATION DATE: 04/30/2003
RESPS:600 HOURS:36,500 COSTS(000):$0
Visa Waiver Program Passenger Arrival and Departure Data
FORMS: NONE
OMB NO: 1117-0001 EXPIRATION DATE: 01/31/2005
RESPS:6,151 HOURS:3,076 COSTS(000):$0
Report of Theft or Loss of Controlled Substances--DEA Form 106
FORMS: FORM-106
OMB NO: 1117-0004 EXPIRATION DATE: 01/31/2005
RESPS:2,000 HOURS:1,034 COSTS(000):$0
Application for Permit to Export Controlled Substances--DEA Form
161
FORMS: FORM-161
OMB NO: 1117-0006 EXPIRATION DATE: 03/31/2006
RESPS:264 HOURS:132 COSTS(000):$0
Application for Individual Manufacturing Quota for a Basic Class
of Controlled Substance
FORMS: 189
OMB NO: 1117-0007 EXPIRATION DATE: 01/31/2005
RESPS:20,000 HOURS:10,000 COSTS(000):$0
Registrants Inventory of Drugs Surrendered--DEA Form 41
FORMS: FORM-41
OMB NO: 1117-0008 EXPIRATION DATE: 03/31/2006
RESPS:818 HOURS:818 COSTS(000):$0
Application for Procurement Quota for Controlled Substances
FORMS: 250
OMB NO: 1117-0010 EXPIRATION DATE: 03/31/2005
RESPS:663,523 HOURS:193,508 COSTS(000):$10,279
U.S. Official Order Forms for Schedules I and II Controlled
Substances (ACCOUNTABLE FORMS), Order Form Requisition
FORMS: DEA-222 DEA-222A
OMB NO: 1117-0012 EXPIRATION DATE: 10/31/2005
RESPS:11,379 HOURS:5,693 COSTS(000):$1,376
Application for Registration (DEA Form 225); Application for
Registration Renewal (DEA Form 225a); Affidavit for Chain
Renewal (DEA Form 225B)
FORMS: 225 225A 225B
OMB NO: 1117-0013 EXPIRATION DATE: 06/30/2004
RESPS:320 HOURS:86 COSTS(000):$0
Application for Permit to Import Controlled Substances for
Domestic and/or Scientific Purposes pursuant to 21 U.S.C. 952
FORMS: FORM-357
OMB NO: 1117-0014 EXPIRATION DATE: 10/31/2005
RESPS:425,009 HOURS:85,232 COSTS(000):$85,739
Application for Registration (DEA Form 224); Application for
Registration Renewal (DEA Form 224a); and Affidavit for Chain
Renewal DEA Retail Pharmacy Registration (DEA Form 224B)
FORMS: 224 224A 224B
OMB NO: 1117-0015 EXPIRATION DATE: 10/31/2005
RESPS:1,251 HOURS:626 COSTS(000):$80
Application for Registration (DEA Form 363), Application for
Registration Renewal (DEA Form 363a), Application for
Registration Renewal (Chain) (DEA Form 363b)
FORMS: 363 363A 363B
OMB NO: 1117-0021 EXPIRATION DATE: 03/31/2005
RESPS:500 HOURS:50,250 COSTS(000):$0
Records and Reports of Registrants: Changes in Record
Requirements for Individual Practitioners
FORMS: NONE
OMB NO: 1117-0024 EXPIRATION DATE: 03/31/2005
RESPS:1,996 HOURS:499 COSTS(000):$0
Reports of Suspicious Orders or Theft/Loss of Listed Chemicals/
Machines
FORMS: NONE
OMB NO: 1117-0029 EXPIRATION DATE: 09/30/2003
RESPS:100 HOURS:400 COSTS(000):$0
Annual Reporting Requirement for Manufacturers of Listed
Chemicals
FORMS: NONE
OMB NO: 1117-0031 EXPIRATION DATE: 01/31/2005
RESPS:3,200 HOURS:1,600 COSTS(000):$0
Application for Registration Under Domestic Chemical Diversion
Control Act of 1993 and Renewal Application for Registration
under Domestic Chemical Diversion Control Act of 1993
FORMS: FORM-510 FORM-510A
OMB NO: 1117-0033 EXPIRATION DATE: 09/30/2003
RESPS:1,200 HOURS:1,200 COSTS(000):$0
Report of Mail Order Transactions
FORMS: NONE
OMB NO: 1117-0034 EXPIRATION DATE: 09/30/2003
RESPS:1,200 HOURS:1,200 COSTS(000):$0
Collection of Laboratory Analysis Data on Drug Samples Testes by
Non-Federal (State and Local Government) Crime Laboratories
FORMS: NONE
OMB NO: 1121-0021 EXPIRATION DATE: 10/31/2003
RESPS:100 HOURS:400 COSTS(000):$0
Accounting System and Financial Capability Questionnaire
FORMS: 7120/1
OMB NO: 1121-0030 EXPIRATION DATE: 03/31/2004
RESPS:3,796 HOURS:1,885 COSTS(000):$0
Capital Punishment report of inmates under sentence of death
FORMS: NPS-8 NPS-8A NPS-8B NPS-8C
OMB NO: 1121-0114 EXPIRATION DATE: 10/31/2004
RESPS:53 HOURS:106 COSTS(000):$0
Victims of Crime Act, Victim Compensation Grant Program, State
Performance Report
FORMS: FORM-7390/6
OMB NO: 1121-0130 EXPIRATION DATE: 04/30/2005
RESPS:445,000 HOURS:2,778 COSTS(000):$0
National Judicial Reporting Program (NJRP)
FORMS: NJRP-1
OMB NO: 1121-0137 EXPIRATION DATE: 05/31/2005
RESPS:70,000 HOURS:43,750 COSTS(000):$0
Firearms Addendum to the Arrestee Drug Abuse Monitoring Program
(ADAM)
FORMS: AD-1
OMB NO: 1121-0140 EXPIRATION DATE: 01/31/2006
RESPS:8,250 HOURS:3,000 COSTS(000):$0
Equal Employment Opportunity Plan Short Form and Certification,
28 CFR Section 42.301 et seq.
FORMS: NONE
OMB NO: 1121-0142 EXPIRATION DATE: 10/31/2003
RESPS:5,900 HOURS:295 COSTS(000):$0
Victims of Crime Act, Crime Victim Assistance Grant Program,
Subgrant Award Report
FORMS: 7390/2A
OMB NO: 1121-0147 EXPIRATION DATE: 04/30/2003
RESPS:1,750 HOURS:5,250 COSTS(000):$0
2000 Census of State and Federal Adult Correctional Facilities
FORMS: CJ-43
OMB NO: 1121-0149 EXPIRATION DATE: 03/31/2004
RESPS:2,400 HOURS:850 COSTS(000):$0
2000 National Survey of Prosecutors
FORMS: NSP-5L NSP-5S
OMB NO: 1121-0152 EXPIRATION DATE: 10/31/2005
RESPS:20,435 HOURS:25,345 COSTS(000):$0
Survey of Inmates in State and Federal Correctional Facilities,
2003
FORMS: NPS-25 NPS-26 NPS-27 NPS-13
OMB NO: 1121-0170 EXPIRATION DATE: 12/31/2005
RESPS:54 HOURS:54 COSTS(000):$0
Crime Victim Compensation State Certification Form
FORMS: 7390/5
OMB NO: 1121-0224 EXPIRATION DATE: 04/30/2005
RESPS:2,565 HOURS:641 COSTS(000):$0
National Youth Gang Survey
FORMS: NONE
OMB NO: 1121-0233 EXPIRATION DATE: 07/31/2003
RESPS:125 HOURS:62 COSTS(000):$0
Certification of Compliance with Eligibility Requirements of
Sec. 826 of the Higher Education Amendments of 1998
FORMS: NONE
OMB NO: 1121-0234 EXPIRATION DATE: 04/30/2003
RESPS:4,200 HOURS:4,200 COSTS(000):$0
Requirements: Data Collection Application for the Juvenile
Accountability Incentive Block Grant Program
FORMS: NONE
OMB NO: 1121-0238 EXPIRATION DATE: 07/31/2003
RESPS:10,780 HOURS:7,875 COSTS(000):$0
Survey of Youth in Residential Placement
FORMS: NONE
OMB NO: 1121-0240 EXPIRATION DATE: 05/31/2003
RESPS:19,000 HOURS:14,000 COSTS(000):$0
2000 Census of State and Local Law Enforcement Agencies
FORMS: CJ-38L CJ-38S
OMB NO: 1121-0245 EXPIRATION DATE: 05/31/2004
RESPS:550 HOURS:416,150 COSTS(000):$23,045
Program Guidance on Environmental Protection Requirements and
Project Status Report
FORMS: N/A
OMB NO: 1121-0246 EXPIRATION DATE: 08/31/2004
RESPS:1,070 HOURS:450 COSTS(000):$0
National Business Survey on White Collar Crime
FORMS: NONE
OMB NO: 1121-0247 EXPIRATION DATE: 10/31/2004
RESPS:19,426 HOURS:17,796 COSTS(000):$0
National Evaluation of the Safe Schools/Healthy Students
Initiative
FORMS: NONE
OMB NO: 1121-0249 EXPIRATION DATE: 09/30/2004
RESPS:16,067 HOURS:3,802 COSTS(000):$0
Deaths in Custody, 2001--series of collections on local jail
jurisdictions, State prisons, and State juvenile facilities
FORMS: NPS-4 NPS-4A NPS-5 NPS-5A CJ-9 CJ-9A CJ-10 CJ-10A
OMB NO: 1121-0250 EXPIRATION DATE: 12/31/2004
RESPS:1,000 HOURS:4,000 COSTS(000):$0
Community Gun Violence Prosecution Program
FORMS: NONE
OMB NO: 1121-0251 EXPIRATION DATE: 09/30/2004
RESPS:300 HOURS:187 COSTS(000):$0
Victimization of People With Disabilities
FORMS: CDER-1A CDER-1B CDER-2A CDER-2B
OMB NO: 1121-0252 EXPIRATION DATE: 12/31/2004
RESPS:556 HOURS:185 COSTS(000):$0
2001 Census of Tribal Justice Agencies
FORMS: CTJA01
OMB NO: 1121-0255 EXPIRATION DATE: 04/30/2005
RESPS:800 HOURS:1,200 COSTS(000):$0
2002 Census of Law Enforcement Training Academies
FORMS: CJ-52
OMB NO: 1121-0258 EXPIRATION DATE: 10/31/2003
RESPS:45 HOURS:45 COSTS(000):$0
Data Collection from Grantees from the Grants to Reduce Violent
Crimes on Campus Program
FORMS: NONE
OMB NO: 1121-0259 EXPIRATION DATE: 12/31/2005
RESPS:500 HOURS:500 COSTS(000):$0
Public Safety Officer Medal of Valor Application
FORMS: 1121
OMB NO: 1125-0001 EXPIRATION DATE: 08/31/2005
RESPS:11,000 HOURS:63,250 COSTS(000):$1,100
Application for Cancellation of Removal: 42A) for Certain
Permanent Residents, and 42B) Adjustment of Status for Certain
Nonpermanent Residents
FORMS: EOIR-42A 42B
OMB NO: 1125-0002 EXPIRATION DATE: 12/31/2005
RESPS:23,417 HOURS:11,708 COSTS(000):$2,576
Notice of Appeal From a Decision of an Immigration Judge
FORMS: EOIR-26
OMB NO: 1125-0004 EXPIRATION DATE: 08/31/2005
RESPS:15,000 HOURS:750 COSTS(000):$0
Alien's Change of Address Form (formerly) Change of Address Form
FORMS: EOIR-33/IC EOIR-33/BIA
OMB NO: 1125-0005 EXPIRATION DATE: 02/28/2006
RESPS:26,000 HOURS:2,600 COSTS(000):$130
Notice of Entry of Appearance as Attorney or Representative
Before the Board of Immigration Appeals
FORMS: EOIR-27
OMB NO: 1125-0006 EXPIRATION DATE: 02/28/2006
RESPS:77,000 HOURS:7,700 COSTS(000):$385
Notice of Entry of Appearance as Attorney or Representative
Before the Immigration Court
FORMS: EOIR-28
OMB NO: 1125-0008 EXPIRATION DATE: 02/28/2006
RESPS:50 HOURS:50 COSTS(000):$0
Notice of Appeal to the Board of Immigration Appeals of Decision
of Adjudicating Official in Practitioner Disciplinary Case
FORMS: EOIR-45
OMB NO: 1125-0009 EXPIRATION DATE: 03/31/2006
RESPS:2,000 HOURS:11,500 COSTS(000):$200
Application for Suspension of Deportation
FORMS: EOIR-40
OMB NO: 1125-0010 EXPIRATION DATE: 01/31/2006
RESPS:3,156 HOURS:1,578 COSTS(000):$347
Notice of Appeal to the Board of Immigration Appeals From a
Decision of an INS Officer
FORMS: EOIR-29
Bureau of Alcohol, Tobacco, Firearms and Explosives
OMB NO: 1140-0001 EXPIRATION DATE: 07/31/2003
RESPS:21,000 HOURS:168 COSTS(000):$0
ATF Distribution Center Contractor Survey
FORMS: ATF-F-1600.7
OMB NO: 1140-0002 EXPIRATION DATE: 07/31/2003
RESPS:250 HOURS:125 COSTS(000):$0
Application for Restoration of Firearms Privileges
FORMS: ATF-F-3210.1
OMB NO: 1140-0003 EXPIRATION DATE: 08/31/2003
RESPS:40,000 HOURS:8,000 COSTS(000):$0
Report of Multiple Sales or Other Disposition of Pistols and
Revolvers
FORMS: ATF-F-3310.4
OMB NO: 1140-0005 EXPIRATION DATE: 07/31/2005
RESPS:11,000 HOURS:5,500 COSTS(000):$0
Application and Permit for Importation of Firearms, Ammunition
and Implements of War
FORMS: 6(5330.3A)PT.I
OMB NO: 1140-0006 EXPIRATION DATE: 09/30/2003
RESPS:9,000 HOURS:4,500 COSTS(000):$0
Application and Permit for Importation of Firearms, Ammunition
and Implements of War
FORMS: ATF-FORM-6 PARTII(5330.3B)
OMB NO: 1140-0007 EXPIRATION DATE: 12/31/2003
RESPS:20,000 HOURS:8,000 COSTS(000):$0
Release and Receipt of Imported firearms, Ammunition and
Implements of War
FORMS: ATF-FORM-6A (5330.3C)
OMB NO: 1140-0008 EXPIRATION DATE: 07/31/2003
RESPS:350 HOURS:1,050 COSTS(000):$0
Application and Permit for Permanent Exportation of Firearms
FORMS: FORM-9(5320.9)
OMB NO: 1140-0009 EXPIRATION DATE: 01/31/2004
RESPS:300 HOURS:150 COSTS(000):$0
Application to Register as an Importer of U.S. Munitions Import
List Articles
FORMS: ATF-F-4587 (5330.4)
OMB NO: 1140-0010 EXPIRATION DATE: 07/31/2003
RESPS:800 HOURS:400 COSTS(000):$0
Application to Transport Interstate or Temporarily Export
Certain National Firearms Act (NFA) Firearms
FORMS: FORM-5320.20
OMB NO: 1140-0011 EXPIRATION DATE: 02/29/2004
RESPS:1,071 HOURS:4,271 COSTS(000):$0
Application to Make and Register a Firearm
FORMS: ATF1(5320.1)
OMB NO: 1140-0012 EXPIRATION DATE: 05/31/2004
RESPS:5,000 HOURS:3,750 COSTS(000):$0
Notice of Firearms Manufactured or Imported
FORMS: ATF-F-2(5320.2)
OMB NO: 1140-0013 EXPIRATION DATE: 07/31/2004
RESPS:26,221 HOURS:13,111 COSTS(000):$0
Application for Tax Exempt Transfer of Firearm and Registration
to Special (Occupational) Taxpayer
FORMS: FORM-3(5320.3)
OMB NO: 1140-0014 EXPIRATION DATE: 08/31/2004
RESPS:11,065 HOURS:44,260 COSTS(000):$0
Application for Tax Paid Transfer and Registration of Firearm
FORMS: FORM-4(5320.4)
OMB NO: 1140-0015 EXPIRATION DATE: 08/31/2004
RESPS:94,974 HOURS:379,896 COSTS(000):$0
Application for Tax Exempt Transfer and Registration of Firearm
FORMS: FORM5(5320.5)
OMB NO: 1140-0016 EXPIRATION DATE: 01/31/2005
RESPS:1,200 HOURS:300 COSTS(000):$0
Application for Registration of Firearms Acquired by Certain
Governmental Entities
FORMS: FORM-10(5320.10
OMB NO: 1140-0029 EXPIRATION DATE: 10/31/2005
RESPS:68,335 HOURS:68,835 COSTS(000):$0
Records and Supporting Data: Daily Summaries, Records of
Production, Storage, and Disposition, and Suppporting Data by
Licensed Explosives Manufacturers and Manufacturers (Limited)
FORMS: ATF-REC-5004/2
OMB NO: 1140-0030 EXPIRATION DATE: 12/31/2004
RESPS:637,570 HOURS:637,570 COSTS(000):$0
RECORDS AND SUPPORTING DATA: Importation, Receipt, Storage, and
Disposition by Licensed Explosives Manufacturers, Importers,
Dealers, and Users
FORMS: ATF-REC-5400/A
OMB NO: 1140-0031 EXPIRATION DATE: 08/31/2005
RESPS:5 HOURS:250 COSTS(000):$0
Records of Acquisition and Dispositon - Registered Importers of
Arms, Ammunition and Implements of War on the U.S. Munitions
imports List ATF REC 7570/1
FORMS: ATF-REC-7570/1
OMB NO: 1140-0032 EXPIRATION DATE: 02/29/2004
RESPS:172,250 HOURS:559,791 COSTS(000):$0
Records of Acquisition and Disposition, Collectors of Firearms
FORMS: 7570/2 7570/3
OMB NO: 1140-0033 EXPIRATION DATE: 04/30/2004
RESPS:3,000 HOURS:1,500 COSTS(000):$0
Request for Disposition of Offense
FORMS: FORM-5020.29
OMB NO: 1140-0034 EXPIRATION DATE: 01/31/2006
RESPS:1,800 HOURS:540 COSTS(000):$4
Application Permit For User Limited Special Fireworks (18 U.S.C.
Chapter 40, Explosives)
FORMS: 5400.21
OMB NO: 1140-0035 EXPIRATION DATE: 04/30/2005
RESPS:5,000 HOURS:1,042 COSTS(000):$0
Firearms Transaction Record Part I--Low Volume-Over-the-Counter
Firearms Transaction Record Part II--Low Volume-Intra-State Non-
Over-the-Counter ATF REC 7570/2
FORMS: ATF-F-4473 (5300.24)PT-I ATF-F-4473 (5300.25)PT-II ATF-REC7570/2
OMB NO: 1140-0036 EXPIRATION DATE: 11/30/2005
RESPS:28,000 HOURS:2,380 COSTS(000):$9,000
Letterhead Request for Information in Regard to Federal Firearms
Dealer's Records (Dealer's Records of Acquisition, Disposition &
Supporting Data)
FORMS: 5300.3
OMB NO: 1140-0037 EXPIRATION DATE: 02/29/2004
RESPS:5 HOURS:3 COSTS(000):$0
Letter Application to Obtain Authorization for the Assembly of a
Nonsporting Rifle or Nonsporting Shotgun for the Purpose of
Testing and Evaluation
FORMS: NONE
OMB NO: 1140-0038 EXPIRATION DATE: 05/31/2004
RESPS:6,000 HOURS:1,500 COSTS(000):$0
Application for License, Collector of Curios and Relics
FORMS: ATF-F-7CR 5310.16
OMB NO: 1140-0039 EXPIRATION DATE: 05/31/2003
RESPS:4,000 HOURS:1,600 COSTS(000):$0
Federal Firearms Licensee Theft/Loss Report ATF F 3310.11
FORMS: ATF-F-3310.11
OMB NO: 1140-0040 EXPIRATION DATE: 07/31/2004
RESPS:18,000 HOURS:22,500 COSTS(000):$0
ATF F 5300.38, Application for an Amended Federal Firearms
License
FORMS: ATF-F-5300.38
OMB NO: 1140-0041 EXPIRATION DATE: 07/31/2004
RESPS:2,107,000 HOURS:458,942 COSTS(000):$0
Implementation of Public Law 103-322, The Violent Crime Control
and Law Enforcement Act of 1994
FORMS: NONE
OMB NO: 1140-0042 EXPIRATION DATE: 01/31/2004
RESPS:32 HOURS:16 COSTS(000):$0
Statement of Process-Marking of Plastic Explosives for the
Purpose of Detection
FORMS: NONE
OMB NO: 1140-0043 EXPIRATION DATE: 09/30/2003
RESPS:183,933 HOURS:198,015 COSTS(000):$0
National Tracing Center Trace Request and NTC Obliterated Serial
Number Trace Request
FORMS: ATF-F-3312.1 ATF-F-3312.2
OMB NO: 1140-0045 EXPIRATION DATE: 08/31/2004
RESPS:9,248,000 HOURS:1 COSTS(000):$0
Implementation of Public Law 103-159, Relating to the Permanent
Provisions of the Brady Handgun Violence Prevention Act. "FINAL
RULE"
FORMS: NONE
OMB NO: 1140-0046 EXPIRATION DATE: 02/28/2005
RESPS:50,000 HOURS:389 COSTS(000):$0
Certification on Agency Letterhead Authorizing Purchase of
Firearm for Official Duties of Law Enforcement Officer
FORMS: NONE
OMB NO: 1140-0047 EXPIRATION DATE: 11/30/2004
RESPS:10,000 HOURS:500 COSTS(000):$0
Race and National Origin Identification
FORMS: ATF-F-2931.1
OMB NO: 1140-0048 EXPIRATION DATE: 05/31/2005
RESPS:400 HOURS:800 COSTS(000):$0
Gang Resistance Education and Training Funding Application
FORMS: ATF-F-6410.1
OMB NO: 1140-0049 EXPIRATION DATE: 11/30/2005
RESPS:75 HOURS:13 COSTS(000):$0
Application for National Firearm Examiner Academy
FORMS: 6330.1
OMB NO: 1140-0050 EXPIRATION DATE: 10/31/2005
RESPS:2,506 HOURS:5,665 COSTS(000):$0
Notice of Proposed Rulemaking Identification Markings Placed on
Firearms 27 CFR 178.92 and 179.102
FORMS: NONE
OMB NO: 1140-0051 EXPIRATION DATE: 01/31/2006
RESPS:31,000 HOURS:600 COSTS(000):$0
Certification of Secure Gun Storage or Safety Devices
FORMS: 5300.42
OMB NO: 1140-0056 EXPIRATION DATE: 05/31/2004
RESPS:300 HOURS:225 COSTS(000):$0
Special Agent Medical Preplacement
FORMS: ATF-F-2300.10
OMB NO: 1140-0057 EXPIRATION DATE: 01/31/2005
RESPS:100 HOURS:17 COSTS(000):$0
Notice of proposed rulemaking: A National Repository for the
collection and inventory of information related to arson and the
criminal misuse of explosives
FORMS: NONE
OMB NO: 1140-0059 EXPIRATION DATE: 04/30/2005
RESPS:1,900 HOURS:317 COSTS(000):$646
Search For Artifacts and Memorabilia
FORMS: NONE
OMB NO: 1140-0060 EXPIRATION DATE: 08/31/2005
RESPS:12,100 HOURS:1,210 COSTS(000):$0
Implementation of Public Law 105-277, Omnibus Consolidated and
Emergency Appropriations Act, 1999, Related to Firearms
Disabilities for Nonimmigrant Aliens
FORMS: NONE
OMB NO: 1140-0061 EXPIRATION DATE: 11/30/2005
RESPS:3,000 HOURS:150 COSTS(000):$0
Certificate of Compliance with 18 USC 922(g)(5)(B)
FORMS: 5330.20
OMB NO: 1140-0063 EXPIRATION DATE: 11/30/2005
RESPS:125 HOURS:63 COSTS(000):$0
Evaluation of Training Arson For Prosecutors (follow-up survey)
Training Program
FORMS: NONE
OMB NO: 1140-0064 EXPIRATION DATE: 05/31/2003
RESPS:150 HOURS:75 COSTS(000):$0
Application for Restoration of Explosives Privileges
FORMS: 5400.29
OMB NO: 1140-0065 EXPIRATION DATE: 08/31/2003
RESPS:30,000 HOURS:1,725 COSTS(000):$10,000
Requisition For Forms or Publications - ATF F 1370.3 Requisition
For Firearms Explosives Forms - ATF F 1370.2
FORMS: 1370.3 1370.2
OMB NO: 1140-0066 EXPIRATION DATE: 07/31/2003
RESPS:325 HOURS:325 COSTS(000):$0
Manufacturers of Ammunition, Records and Supporting Data of
Ammunition Manufactured and Disposed of
FORMS: ATF-REC-5000/2
OMB NO: 1140-0067 EXPIRATION DATE: 08/31/2005
RESPS:4,304,000 HOURS:76,611 COSTS(000):$0
Licensed Firearms Manufacturers Records of Production,
Disposition, and Supporting Data
FORMS: 5300/1
OMB NO: 1140-0070 EXPIRATION DATE: 08/31/2003
RESPS:1,000 HOURS:15,000 COSTS(000):$741,300
Application for Explosives License or Permit
FORMS: 5400.13 5400.16
OMB NO: 1140-0071 EXPIRATION DATE: 03/31/2006
RESPS:20,014 HOURS:60,342 COSTS(000):$0
Notification to Fire Marshal and Chief, Law Enforcement Officer
of Storage of Explosive Material
FORMS: NONE
OMB NO: 1140-0079 EXPIRATION DATE: 08/31/2003
RESPS:50,000 HOURS:25,000 COSTS(000):$0
Transactions among licensee/permittees and transactions among
licensees and holders of used permits.
FORMS: NONE
OMB NO: 1140-0080 EXPIRATION DATE: 08/31/2003
RESPS:1,000 HOURS:170 COSTS(000):$0
Notification of Change of Mailing or Premise Address
FORMS: NONE
OMB NO: 1140-0082 EXPIRATION DATE: 08/31/2003
RESPS:50,000 HOURS:416 COSTS(000):$0
Certificate of Knowledge of State Laws, Submission of Water
Pollution Act
FORMS: NONE
OMB NO: 1140-0084 EXPIRATION DATE: 06/30/2003
RESPS:15,000 HOURS:7,500 COSTS(000):$0
Application and Permit for Temporary Importation of Firearms and
Ammunition by Nonimmigrant Aliens
FORMS: 6NIA
OMB NO: 1190-0001 EXPIRATION DATE: 11/30/2005
RESPS:4,873 HOURS:48,730 COSTS(000):$0
Procedures for the Administration of Section 5 of the Voting
Rights Act of 1965
FORMS: NONE
OMB NO: 1190-0004 EXPIRATION DATE: 02/29/2004
RESPS:6,000 HOURS:48,000 COSTS(000):$0
Nondiscrimination on the Basis of Disability in State and Local
Government Services
FORMS: NONE
OMB NO: 1190-0005 EXPIRATION DATE: 02/29/2004
RESPS:10 HOURS:320 COSTS(000):$0
Nondiscrimination on the Basis of Disability in State and Local
Government Services (Certification).
FORMS: NONE
OMB NO: 1190-0006 EXPIRATION DATE: 02/29/2004
RESPS:15,000 HOURS:90,000 COSTS(000):$0
Nondiscrimination on the Basis of Disability in State and Local
Government Services (Self-Evaluation).
FORMS: NONE
OMB NO: 1190-0008 EXPIRATION DATE: 02/29/2004
RESPS:1,560 HOURS:780 COSTS(000):$0
Complaint Form, Coordination and Review Section, Civil Rights
Division, Department of Justice
FORMS: NONE
OMB NO: 1190-0009 EXPIRATION DATE: 02/29/2004
RESPS:5,000 HOURS:3,750 COSTS(000):$0
Title II of the Americans with Disabilities Act of 1990/Section
504 of the Rehabilitation Act of 1973 Discrimination Complaint
Form.
FORMS: NONE
OMB NO: 1205-0001 EXPIRATION DATE: 02/29/2004
RESPS:416 HOURS:416 COSTS(000):$0
Work Application/Job Order Recordkeeping
FORMS: N/A
OMB NO: 1205-0009 EXPIRATION DATE: 04/30/2003
RESPS:12 HOURS:5,512 COSTS(000):$0
Distribution of Characteristics of the Insured Unemployed
FORMS: ETA-203
OMB NO: 1205-0025 EXPIRATION DATE: 09/30/2003
RESPS:94,792 HOURS:47,781 COSTS(000):$3,060
Job Corps Application Data
FORMS: ETA-652 ETA-655 ETA-682
OMB NO: 1205-0028 EXPIRATION DATE: 07/31/2003
RESPS:5,512 HOURS:3,675 COSTS(000):$0
Weekly Claims and Extended Benefits Data and Weekly Initial and
Continued Weeks Claimed
FORMS: 539 538
OMB NO: 1205-0029 EXPIRATION DATE: 12/31/2004
RESPS:212 HOURS:848 COSTS(000):$0
Interstate Arrangement for Combining Employment and Wages
FORMS: ETA-586
OMB NO: 1205-0033 EXPIRATION DATE: 01/31/2004
RESPS:93,000 HOURS:7,750 COSTS(000):$0
Job Corps Health Questionnaire
FORMS: ETA-6-53
OMB NO: 1205-0035 EXPIRATION DATE: 02/29/2004
RESPS:62,429 HOURS:13,567 COSTS(000):$177
Job Corps Placement and Assistance Record
FORMS: ETA-678
OMB NO: 1205-0039 EXPIRATION DATE: 06/30/2004
RESPS:3,046 HOURS:5,537 COSTS(000):$3
Program Monitoring Report and Job Srvice Complaint Form
FORMS: ETA-8429 ETA-5148
OMB NO: 1205-0040 EXPIRATION DATE: 08/31/2003
RESPS:434 HOURS:1,776 COSTS(000):$0
Senior Community Service Employment Program (SCSEP)
FORMS: ETA-5140 ETA-8705 ETA-5163
OMB NO: 1205-0051 EXPIRATION DATE: 01/31/2005
RESPS:162,795 HOURS:10,177 COSTS(000):$0
Employment and Training Administration (ETA) Disaster
Unemployment Assistance (DUA) Handbook and Operating Forms,
Including ETA 90-2, Disaster Payment Activities Under the....
FORMS: ETA-90-2
OMB NO: 1205-0132 EXPIRATION DATE: 03/31/2005
RESPS:835 HOURS:2,121 COSTS(000):$0
Unemployment Insurance (UI) State Quality Service Plan (SQSP)
FORMS: NONE
OMB NO: 1205-0134 EXPIRATION DATE: 06/30/2004
RESPS:5,000 HOURS:3,500 COSTS(000):$0
Forms for Agricultural Recruitment System of Services to
Migratory Workers and Their Employers; Application for Alien
Certification
FORMS: ETA-790 ETA-795
OMB NO: 1205-0162 EXPIRATION DATE: 07/31/2003
RESPS:212 HOURS:1,272 COSTS(000):$0
Statement of Expenditures and Adjustments of Federal Funds for
Unemployment Compensation for Federal Employees and
Ex-Servicemembers
FORMS: ETA-191
OMB NO: 1205-0192 EXPIRATION DATE: 07/31/2003
RESPS:1,400 HOURS:350 COSTS(000):$0
Petition for Adjustment Assistance/Solicitud De Asistencia Para
Ajuste
FORMS: ETA-8560 ETA-8559
OMB NO: 1205-0197 EXPIRATION DATE: 10/31/2003
RESPS:1,500 HOURS:4,500 COSTS(000):$0
Business Confidential Data Request
FORMS: ETA-9014
OMB NO: 1205-0199 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:1 COSTS(000):$0
Title XII Advances and Voluntary Repayment Process
FORMS: NONE
OMB NO: 1205-0207 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:3 COSTS(000):$0
Procedures for Classifying Labor Surplus Areas
FORMS: NONE
OMB NO: 1205-0219 EXPIRATION DATE: 04/30/2003
RESPS:314,570 HOURS:84,741 COSTS(000):$0
Standard Job Corps Request for Proposal and Related Contractor
Information Gathering
FORMS: NONE
OMB NO: 1205-0222 EXPIRATION DATE: 04/30/2004
RESPS:3,180 HOURS:53 COSTS(000):$0
Administrative Procedures - 20 CFR 601 Including Form MA 8-7
FORMS: MA-8-7
OMB NO: 1205-0223 EXPIRATION DATE: 10/31/2003
RESPS:238,929 HOURS:47,520 COSTS(000):$0
Title 29 CFR Part 29 -- Labor Standards for the Registration of
Apprenticeship Programs
FORMS: ETA-671
OMB NO: 1205-0224 EXPIRATION DATE: 10/31/2003
RESPS:63,736 HOURS:6,264 COSTS(000):$0
Title 29 CFR Part 30 - Equal Employment Opportunity in
Apprenticeship and Training
FORMS: ETA-9039
OMB NO: 1205-0228 EXPIRATION DATE: 01/31/2004
RESPS:1 HOURS:14 COSTS(000):$0
Preliminary Estimates of Average Employer Contribution Rates
FORMS: ETA-205
OMB NO: 1205-0238 EXPIRATION DATE: 04/30/2004
RESPS:212 HOURS:39,388 COSTS(000):$985
Income and Eligibility Verification
FORMS: NONE
OMB NO: 1205-0309 EXPIRATION DATE: 04/30/2004
RESPS:1 HOURS:4 COSTS(000):$0
Attestations by Employers Using Alien Crewmmembers for Longshore
Activities in U.S. Ports
FORMS: ETA-9033
OMB NO: 1205-0310 EXPIRATION DATE: 08/31/2003
RESPS:334,275 HOURS:310,421 COSTS(000):$0
Labor Condition Application and Requirements for Employers Using
Nonimmigrants on H-1B Visas
FORMS: ETA-9035 ETA-9035E WH4
OMB NO: 1205-0352 EXPIRATION DATE: 03/31/2005
RESPS:350 HOURS:1,050 COSTS(000):$0
Attestations by Employers Using Alien Crewmembers for Longshore
Activities at Locations in the State of Alaska
FORMS: ETA-9033A
OMB NO: 1205-0353 EXPIRATION DATE: 02/29/2004
RESPS:424 HOURS:106 COSTS(000):$0
Worker Profiling and Reemployment Services Activity and Worker
Profiling and Reemployment Services Outcomes
FORMS: ETA9048 ETA9049
OMB NO: 1205-0373 EXPIRATION DATE: 04/30/2003
RESPS:1 HOURS:2,176 COSTS(000):$0
Baseline and Post-Program Employment Rate for the Youth
Opportunity Area Demonstration
FORMS: NONE
OMB NO: 1205-0385 EXPIRATION DATE: 03/31/2004
RESPS:1,204 HOURS:2,026 COSTS(000):$0
Welfare to Work (WtW) Formula/Competitive Cumulative Quarterly
Status Reports
FORMS: ETA-9068 ETA-9068-1
OMB NO: 1205-0391 EXPIRATION DATE: 08/31/2004
RESPS:2,302 HOURS:1,420 COSTS(000):$0
Center for Employment and Training (CET) Follow-up Survey
FORMS: NONE
OMB NO: 1205-0392 EXPIRATION DATE: 02/29/2004
RESPS:200 HOURS:9,500 COSTS(000):$325
Trade Act Participant Report (TAPR), a GPRA-compliant data
collection and reporting system
FORMS: NONE
OMB NO: 1205-0397 EXPIRATION DATE: 04/30/2005
RESPS:846 HOURS:282 COSTS(000):$0
Quantum Opportunity Program (QOP) Demonsration Net Impact
Evaluation
FORMS: NONE
OMB NO: 1205-0398 EXPIRATION DATE: 05/31/2004
RESPS:59 HOURS:1,475 COSTS(000):$0
Planning Guidance and Instructions for Submission of the
Strategic Five Year State Plan and Plan Modifications for Title
I of the Workforce Investment Act of 1988 (Workforce
Investment....
FORMS: NONE
OMB NO: 1205-0404 EXPIRATION DATE: 10/31/2005
RESPS:318 HOURS:80 COSTS(000):$0
Labor Certification for the Temporary Employment of Nonimmigrant
Aliens in Agriculture in the United States; Administrative
Measures to Improve Program Performance
FORMS: NONE
OMB NO: 1205-0407 EXPIRATION DATE: 04/30/2003
RESPS:57 HOURS:19,095 COSTS(000):$0
State Unified Plan Planning Guidance for State Unified Plans
Submitted Under Section 501 of the Workforce Invesment Act of
1998.
FORMS: NONE
OMB NO: 1205-0408 EXPIRATION DATE: 02/29/2004
RESPS:672 HOURS:672 COSTS(000):$0
Workforce Investment Act Cumulative Quarterly Financial
Reporting for Funds Allotted to States for: 1) Services to
Youth, 2) Services to Adults, 3) Services to Dislocated
Workers........
FORMS: 9076-A 9076-B 9076-C 9076-D 9076-E 9076-F
OMB NO: 1205-0410 EXPIRATION DATE: 06/30/2003
RESPS:16 HOURS:64 COSTS(000):$0
Employers' Use and Assessment of the WOTC and Welfare-to-Work
Tax Credit Programs
FORMS: NONE
OMB NO: 1205-0412 EXPIRATION DATE: 08/31/2003
RESPS:1,200 HOURS:300 COSTS(000):$0
Benefit-Cost Analysis of the Self-Employment Assistance Program
for the United States Unemployment Insurance Program
FORMS: NONE
OMB NO: 1205-0414 EXPIRATION DATE: 12/31/2005
RESPS:576 HOURS:51,840 COSTS(000):$0
MIS Requirements for Youth Opportunity Grants
FORMS: ETA-9086 ETA-9087
OMB NO: 1205-0416 EXPIRATION DATE: 10/31/2003
RESPS:75 HOURS:1,500 COSTS(000):$0
Disability Employment and Initiatives Grant Program
FORMS: APR-ETA-9077 PCR-ETA-9078
OMB NO: 1205-0417 EXPIRATION DATE: 12/31/2003
RESPS:162 HOURS:46,656 COSTS(000):$0
PY 2002 Workforce Information Grant Plan and Annual Performance
Report
FORMS: NONE
OMB NO: 1205-0420 EXPIRATION DATE: 08/31/2005
RESPS:318 HOURS:758,236 COSTS(000):$19,905
WIA Management Information and Rreporting System
FORMS: ETA-9090 ETA-9091
OMB NO: 1205-0421 EXPIRATION DATE: 09/30/2005
RESPS:80,919 HOURS:33,373 COSTS(000):$0
O*NET Data Collection Program
FORMS: NONE
OMB NO: 1205-0423 EXPIRATION DATE: 03/31/2004
RESPS:1,800 HOURS:1,800 COSTS(000):$0
Workforce Investment Act (WIA) Employment and Training
Administration (ETA) Financial Reporting Requirements for Indian
and Native American (INA) Grantee Activities
FORMS: ETA-9080
OMB NO: 1205-0424 EXPIRATION DATE: 11/30/2004
RESPS:108 HOURS:3,024 COSTS(000):$0
Re-employment Services Plan Narrative and Progress Report
FORMS: ETA-9096
OMB NO: 1205-0425 EXPIRATION DATE: 12/31/2004
RESPS:42,833 HOURS:88,899 COSTS(000):$0
Reporting and Performance Standards System for Migrant and
Seasonal Farmworker Programs Under Title I, Section 167 of the
Workforce Investment Act (WIA)
FORMS: ETA-9093 ETA-9094 ETA-9095
OMB NO: 1205-0426 EXPIRATION DATE: 08/31/2004
RESPS:83,728 HOURS:17,485 COSTS(000):$0
Placement Verification and Follow-up of Job Corps Participants
FORMS: NONE
OMB NO: 1205-0428 EXPIRATION DATE: 10/31/2004
RESPS:636 HOURS:636 COSTS(000):$0
Workforce Investment Act (WIA) Employment and Training
Administration (ETA) Financial Reporting Requirements for
NATIONAL FARMWORKERS JOBS PROGRAM (NFJP) UNDER TITLE I of the Act
FORMS: ETA-9092
OMB NO: 1205-0429 EXPIRATION DATE: 07/31/2003
RESPS:5,080 HOURS:15,650 COSTS(000):$0
Reporting and Performance Standards System for Migrant and
Seasonal Farmworker :Youth Programs Under Title I-D, Section 167
of the Workforce Investment Act (WIA)
FORMS: ETA-9096 ETA-9097 ETA-9098
OMB NO: 1210-0060 EXPIRATION DATE: 02/28/2005
RESPS:116 HOURS:1 COSTS(000):$163
Procedure for Application for Exemption from the Prohibited
Transaction Provisions of Section 408(a) of the Employee
Retirement Income Security Act of 1974 (ERISA)
FORMS: NONE
OMB NO: 1210-0061 EXPIRATION DATE: 11/30/2004
RESPS:191,000 HOURS:31,900 COSTS(000):$71
Class Exemption 81-8 for Investment of Plan Assets in Certain
types of Short-Term Investments
FORMS: NONE
OMB NO: 1210-0064 EXPIRATION DATE: 01/31/2004
RESPS:25 HOURS:2 COSTS(000):$0
Prohibited Transaction Exemption 80-83--Involving Purchase of
Securities where issuer may use proceeds to Reduce indebtedness
to parties in interest
FORMS: NONE
OMB NO: 1210-0076 EXPIRATION DATE: 08/31/2004
RESPS:1,310 HOURS:1 COSTS(000):$283
Regulatoin Relating to Loans to Plan Participants and to the Plan
FORMS: NONE
OMB NO: 1210-0098 EXPIRATION DATE: 11/30/2004
RESPS:42 HOURS:53 COSTS(000):$38
Prohibited Transaction Class Exemption 96-62; Process for
Expedited Approval of an Exemption for Prohibited Transaction
FORMS: NONE
OMB NO: 1210-0100 EXPIRATION DATE: 05/31/2003
RESPS:1 HOURS:3 COSTS(000):$0
Definition of Plan Assets - Participant Contributions
FORMS: NONE
OMB NO: 1210-0101 EXPIRATION DATE: 06/30/2003
RESPS:9,602,000 HOURS:7,200 COSTS(000):$841
Notice of Enrollment Rights
FORMS: NONE
OMB NO: 1210-0105 EXPIRATION DATE: 11/30/2004
RESPS:10,000 HOURS:333 COSTS(000):$5
Notice to Participants and Beneficiaries and the Federal
Government to Electing one Percent Increased Cost Exemption
FORMS: NONE
OMB NO: 1210-0106 EXPIRATION DATE: 10/31/2004
RESPS:200 HOURS:10 COSTS(000):$0
Calculation and Disclosure of Documentation of Eligibility for
Exemption
FORMS: NONE
OMB NO: 1210-0110 EXPIRATION DATE: 10/31/2004
RESPS:863,682 HOURS:1,847,163 COSTS(000):$546,789
Form 5500 Annual Return/Report of Employee Benefit Plan
FORMS: FORM-5500
OMB NO: 1210-0111 EXPIRATION DATE: 02/28/2005
RESPS:8,400 HOURS:4,200 COSTS(000):$0
Prohibited Transactions Exemption 98-54 Relating to Certain
Employee Benefit Plan Foreign Exchange Transactions Executed
Pursuant to Standing Instructions
FORMS: NONE
OMB NO: 1210-0112 EXPIRATION DATE: 12/31/2005
RESPS:1,000 HOURS:95 COSTS(000):$4
Furnishing Documents to the Secretary of Labor on Request under
ERISA section 104(a)(6)
FORMS: NONE
OMB NO: 1210-0113 EXPIRATION DATE: 04/30/2003
RESPS:770,000 HOURS:785,000 COSTS(000):$1,100
National Medical Support Notice -- Part B
FORMS: NONE
OMB NO: 1210-0114 EXPIRATION DATE: 01/31/2006
RESPS:123,500 HOURS:466,667 COSTS(000):$46
Disclosures by Insurers to General Account Policyholders
FORMS: NONE
OMB NO: 1210-0115 EXPIRATION DATE: 04/30/2003
RESPS:840 HOURS:9,100 COSTS(000):$421
Proposed Class Exemption for Cross-Trades of Securities by Index
and Model-Driven Funds
FORMS: NONE
OMB NO: 1210-0116 EXPIRATION DATE: 11/30/2003
RESPS:2,678 HOURS:874 COSTS(000):$394
Annual Report for Multiple Employer Welfare Arrangements and
Certain Entities Claiming Exception (Form M-1)
FORMS: M-1
OMB NO: 1210-0117 EXPIRATION DATE: 05/31/2005
RESPS:7,200 HOURS:2,400 COSTS(000):$3
Application for EFAST-1 Electronic Signature and Codes for EFAST
Transmitters and Software Developers
FORMS: EFAST-1
OMB NO: 1210-0118 EXPIRATION DATE: 11/30/2003
RESPS:1,050 HOURS:5,710 COSTS(000):$272
The Voluntary Fiduciary Correction Program and Prohibited
Transaction Class Exemption
FORMS: NONE
OMB NO: 1210-0119 EXPIRATION DATE: 01/31/2004
RESPS:45 HOURS:1 COSTS(000):$104
Petition for Finding under Section 3(40) of ERISA
FORMS: NONE
OMB NO: 1210-0121 EXPIRATION DATE: 05/31/2005
RESPS:50,000 HOURS:5,042 COSTS(000):$2,447
Consent to Receive Employee Benefit Plan Disclosure
Electronically
FORMS: NONE
OMB NO: 1210-0122 EXPIRATION DATE: 04/30/2003
RESPS:11,956,600 HOURS:166,129 COSTS(000):$9,351
Notice of Blackout Period Under ERISA
FORMS: NONE
OMB NO: 1215-0017 EXPIRATION DATE: 05/31/2004
RESPS:5,800,000 HOURS:926,156 COSTS(000):$0
Records To Be Kept By Employers - FLSA
FORMS: NONE
OMB NO: 1215-0022 EXPIRATION DATE: 03/31/2006
RESPS:26,100 HOURS:6,525 COSTS(000):$10
Payment of Compensation Without Award
FORMS: LS-206
OMB NO: 1215-0023 EXPIRATION DATE: 03/31/2006
RESPS:18,900 HOURS:4,725 COSTS(000):$8
Notice of Controversion of Right to Compensation
FORMS: LS-207
OMB NO: 1215-0024 EXPIRATION DATE: 03/31/2006
RESPS:18,950 HOURS:4,738 COSTS(000):$11
Notice of Final Payment or Suspension of Compensation Benefits
FORMS: LS-208
OMB NO: 1215-0031 EXPIRATION DATE: 10/31/2004
RESPS:26,660 HOURS:6,705 COSTS(000):$11
Employer's First Report of Injury or Occupational Disease
LS-202; Physician's Report on Impairment of Vision LS-205;
Employer's Supplementary Report of Accident or Occupational
Illness LS-210
FORMS: LS-202 LS-205 LS-210
OMB NO: 1215-0032 EXPIRATION DATE: 10/31/2005
RESPS:350 HOURS:69 COSTS(000):$0
Applications for Authority to Employ Full-Time Students at
Subminimum Wages in Retail or Service Establishments or
Agriculture
FORMS: WH-200 WH-202
OMB NO: 1215-0055 EXPIRATION DATE: 11/30/2003
RESPS:1,610,030 HOURS:187,663 COSTS(000):$0
Health Insurance Claim Form
FORMS: OWCP-1500
OMB NO: 1215-0056 EXPIRATION DATE: 04/30/2005
RESPS:1,700 HOURS:800 COSTS(000):$1
(1) Comparability of Current Work to Coal Mine Employment; (2)
Coal Mine Employment Afidavit; (3) Afidavit of Deceased Miner's
Condition
FORMS: CM-913 CM-918 CM-1093
OMB NO: 1215-0057 EXPIRATION DATE: 11/30/2003
RESPS:2,700 HOURS:225 COSTS(000):$0
Authorization for Release of Medical Information
FORMS: CM-936
OMB NO: 1215-0058 EXPIRATION DATE: 10/31/2004
RESPS:10,800 HOURS:2,283 COSTS(000):$4
Operator Controversion, Operator Response, Operator Response to
Response to Notice of Claim
FORMS: CM-970 CM-970A CM-2970 CM-2970A
OMB NO: 1215-0059 EXPIRATION DATE: 03/31/2004
RESPS:4,000 HOURS:667 COSTS(000):$2
Notice of Issuance of Insurance Policy
FORMS: CM-921
OMB NO: 1215-0060 EXPIRATION DATE: 10/31/2004
RESPS:3,522 HOURS:881 COSTS(000):$12
Request for State or Federal Workers' Compensation Information
FORMS: CM-905
OMB NO: 1215-0061 EXPIRATION DATE: 04/30/2004
RESPS:1,000 HOURS:167 COSTS(000):$0
Certification by School Official
FORMS: CM-981
OMB NO: 1215-0064 EXPIRATION DATE: 08/31/2003
RESPS:9,000 HOURS:1,800 COSTS(000):$3
Notice of Termination, Suspension, Reduction or Increase in
Benefit Payments
FORMS: CM-908
OMB NO: 1215-0080 EXPIRATION DATE: 11/30/2005
RESPS:15 HOURS:5 COSTS(000):$0
Application for Authority for an Institution on Higher Education
to Employ its Full-time Students at Subminimum Wages Under
Regulations Part 519
FORMS: WH-201
OMB NO: 1215-0083 EXPIRATION DATE: 01/31/2006
RESPS:10 HOURS:2 COSTS(000):$0
Application for Federal Certificate of Age
FORMS: WH-14
OMB NO: 1215-0084 EXPIRATION DATE: 06/30/2005
RESPS:1 HOURS:2,208 COSTS(000):$0
Report of Changes That May Afect Your Black Lung Benefits
FORMS: CM-929
OMB NO: 1215-0105 EXPIRATION DATE: 03/31/2004
RESPS:500 HOURS:125 COSTS(000):$0
Request for Employment Information
FORMS: CA-1027
OMB NO: 1215-0112 EXPIRATION DATE: 06/30/2003
RESPS:1,700 HOURS:425 COSTS(000):$0
Request for Earnings Information
FORMS: LS-426
OMB NO: 1215-0113 EXPIRATION DATE: 11/30/2005
RESPS:12,000 HOURS:4,800 COSTS(000):$0
Certificate of Medical Necessity
FORMS: CM-893
OMB NO: 1215-0116 EXPIRATION DATE: 08/31/2004
RESPS:23 HOURS:31 COSTS(000):$0
Notice of Law Enforcement Officer's Injury or Occupational
Disease (CA-721); Notice of Law Enforcement Officer's Death
(CA-722)
FORMS: CA-721 CA-722
OMB NO: 1215-0119 EXPIRATION DATE: 03/31/2006
RESPS:462,000 HOURS:2 COSTS(000):$0
Requirements of a Bona Fide Thrift or Savings Plan (29 CFR Part
547) and Requirements of a Bona Fide Profit-Sharing Plan or
Trust (29 CFR Part 549)
FORMS: NONE
OMB NO: 1215-0120 EXPIRATION DATE: 08/31/2004
RESPS:1 HOURS:4 COSTS(000):$0
29 CFR Part 575 - Waiver of Child Labor Provisions for
Agricultural Employment of 10 and 11 Year Old Minors in Hand
Harvesting of Short Season Crops
FORMS: NONE
OMB NO: 1215-0121 EXPIRATION DATE: 03/31/2006
RESPS:14,014 HOURS:7,145 COSTS(000):$0
Work Experience and Career Exploration Programs (20 CFR 570.35A)
FORMS: NONE
OMB NO: 1215-0124 EXPIRATION DATE: 06/30/2004
RESPS:150 HOURS:1 COSTS(000):$0
Maintenance of Receipt for Benefits Paid by a Coal Mine Operator
FORMS: CM-200
OMB NO: 1215-0149 EXPIRATION DATE: 03/31/2006
RESPS:9,280,960 HOURS:8,700,000 COSTS(000):$371
Optional Use Payroll Form Under the Davis-Bacon Act
FORMS: WH-347
OMB NO: 1215-0150 EXPIRATION DATE: 09/30/2004
RESPS:64,026 HOURS:62,554 COSTS(000):$0
Labor Standards for Federal Service Contracts - 29 CFR, Part 4
FORMS: NONE
OMB NO: 1215-0151 EXPIRATION DATE: 02/28/2005
RESPS:50,000 HOURS:16,667 COSTS(000):$18
Request for Information on Earnings, Dual Benefits, Dependents
and Third Party Settlements
FORMS: CA-1032
OMB NO: 1215-0154 EXPIRATION DATE: 05/31/2005
RESPS:5,900 HOURS:492 COSTS(000):$2
Claim for Continuance of Compensation
FORMS: CA-12
OMB NO: 1215-0155 EXPIRATION DATE: 04/30/2004
RESPS:1,895 HOURS:1,210 COSTS(000):$0
Claim for Compensation by Dependents Information Reports
FORMS: CA-5 CA-5B CA-1031 CA-1074 CA-1085 CA-1093 CA-1615 CA-1617
CA-1618
OMB NO: 1215-0170 EXPIRATION DATE: 10/31/2005
RESPS:328,000 HOURS:82,406 COSTS(000):$0
Application of the Employee Polygraph Protection Act
FORMS: NONE
OMB NO: 1215-0171 EXPIRATION DATE: 11/30/2004
RESPS:500 HOURS:350 COSTS(000):$0
Application for Approval of a Representative's Fee in Black Laor
FORMS: CM-972
OMB NO: 1215-0181 EXPIRATION DATE: 07/31/2003
RESPS:10,107,000 HOURS:718,529 COSTS(000):$0
29 CFR Part 825, The Family and Medical Leave Act of 1993
FORMS: WH-380 WH-381
OMB NO: 1218-0011 EXPIRATION DATE: 03/31/2005
RESPS:885,304 HOURS:134,819 COSTS(000):$0
Subpart A (General Provisions) and Subpart B (Confined and
Enclosed Spaces and Other Dangerous Atmpospheres) of 29 CFR part
1915
FORMS: NONE
OMB NO: 1218-0020 EXPIRATION DATE: 06/30/2004
RESPS:200 HOURS:11,050 COSTS(000):$0
Application for Training Grant
FORMS: NONE
OMB NO: 1218-0064 EXPIRATION DATE: 12/31/2004
RESPS:55,132 HOURS:14,767 COSTS(000):$1
Notice of Alleged Safety and Health Hazards, OSHA-7 Form
FORMS: OSHA-7
OMB NO: 1218-0065 EXPIRATION DATE: 02/29/2004
RESPS:5,030,002 HOURS:613,127 COSTS(000):$0
Access to Employee Exposure and Medical Records (29 CFR
1910.1020)
FORMS: NONE
OMB NO: 1218-0067 EXPIRATION DATE: 02/28/2005
RESPS:88,578 HOURS:57,464 COSTS(000):$117
Underground Construction Standard
FORMS: NONE
OMB NO: 1218-0113 EXPIRATION DATE: 09/30/2004
RESPS:132,737 HOURS:218,090 COSTS(000):$0
Construction Crane or Derrick Annual Inspection Record
FORMS: NONE
OMB NO: 1218-0115 EXPIRATION DATE: 11/30/2004
RESPS:67,773 HOURS:5,416 COSTS(000):$431
Cranes and Derricks Standards for Construction: Notification of
Operational Specification and Hand Signals
FORMS: NONE
OMB NO: 1218-0121 EXPIRATION DATE: 09/30/2004
RESPS:167,569 HOURS:124,357 COSTS(000):$0
Powered Platforms for Building Maintenace (29 CFR 1910.66)
FORMS: NONE
OMB NO: 1218-0147 EXPIRATION DATE: 02/29/2004
RESPS:58 HOURS:1,345 COSTS(000):$0
Definition and Requirements for a Nationally Recognized Testing
Laboratory (29 CFR 1910.7)
FORMS: NONE
OMB NO: 1218-0150 EXPIRATION DATE: 05/31/2004
RESPS:94,561,759 HOURS:2,462,279 COSTS(000):$0
Standard on the Control of Hazardous Energy Sources
(Lockout/Tagout) (29 CFR 1910.147)
FORMS: NONE
OMB NO: 1218-0151 EXPIRATION DATE: 11/30/2004
RESPS:2,750 HOURS:229 COSTS(000):$0
Cranes and Derricks Standards for Construction: Posting Weight
and Load Capacity of Personnel Platforms
FORMS: NONE
OMB NO: 1218-0184 EXPIRATION DATE: 09/30/2003
RESPS:785 HOURS:394 COSTS(000):$26
4,4'-Methylenedianline (MDA) General Industry 1910.1050
FORMS: NONE
OMB NO: 1218-0185 EXPIRATION DATE: 12/31/2005
RESPS:394,889 HOURS:121,344 COSTS(000):$6,191
Cadmium in General Industry (29 CFR 1910.1027)
FORMS: NONE
OMB NO: 1218-0186 EXPIRATION DATE: 12/31/2005
RESPS:376,889 HOURS:39,331 COSTS(000):$2,237
Cadmium in Construction (29 CFR 1926.1127)
FORMS: NONE
OMB NO: 1218-0189 EXPIRATION DATE: 12/31/2005
RESPS:5,782,074 HOURS:1,560,718 COSTS(000):$69,083
Lead in Construction 1926.62
FORMS: NONE
OMB NO: 1218-0190 EXPIRATION DATE: 09/30/2003
RESPS:515,094 HOURS:34,496 COSTS(000):$0
Electrical Protective Equipment (1910.137), and Electric Power
Generation, Transmission, and Distribution (1910.269) Standard
FORMS: NONE
OMB NO: 1218-0205 EXPIRATION DATE: 05/31/2003
RESPS:5,965,572 HOURS:1,834,279 COSTS(000):$0
Personal Protection Equipment for General Industry (29 CFR
1910.132)
FORMS: NONE
OMB NO: 1218-0215 EXPIRATION DATE: 05/31/2003
RESPS:87,000 HOURS:2,255 COSTS(000):$0
Personal Protective Equipment (PPE) for Shipyard Employment (29
CFR Part 1915)
FORMS: NONE
OMB NO: 1218-0216 EXPIRATION DATE: 12/31/2003
RESPS:60 HOURS:3 COSTS(000):$0
Manfacturer's Certification of Modifications Made to
Construction Aerial Lifts
FORMS: NONE
OMB NO: 1218-0218 EXPIRATION DATE: 05/31/2004
RESPS:1,170,733 HOURS:131,708 COSTS(000):$11,941
The Hydrostatic Testing Provision of the Standard on Portable
Fire Extinguishers (29 CFR 1910.157(f)(16))
FORMS: NONE
OMB NO: 1218-0219 EXPIRATION DATE: 09/30/2005
RESPS:8 HOURS:1 COSTS(000):$0
Servicing Multi-Piece and Single Piece Rim Wheels (29 CFR
1910.177(d)(3)(iv))
FORMS: NONE
OMB NO: 1218-0244 EXPIRATION DATE: 01/31/2006
RESPS:4,410 HOURS:49,254 COSTS(000):$0
OSHA Strategic Partnership Program for Worker Safey and Health
FORMS: NONE
OMB NO: 1218-0246 EXPIRATION DATE: 03/31/2004
RESPS:5,340,499 HOURS:1,236,764 COSTS(000):$0
Bloodborne Pathogens Standard (Needlestick Safety and Prevention
Act)
FORMS: NONE
OMB NO: 1218-0247 EXPIRATION DATE: 11/30/2005
RESPS:979 HOURS:8,522 COSTS(000):$0
Occupational Safety and Health State Plan Information
FORMS: NONE
OMB NO: 1219-0020 EXPIRATION DATE: 08/31/2004
RESPS:10 HOURS:50 COSTS(000):$0
Operations Under Water (30 CFR 75.1716, 75.1716-1, and 75.1716.3
FORMS: NONE
OMB NO: 1219-0024 EXPIRATION DATE: 10/31/2004
RESPS:546 HOURS:221 COSTS(000):$0
Application for Waiver of Surface Facilities Requirements (30
CFR 71.403, 71.404, 75.1712-4, and 75.1712-5)
FORMS: NONE
OMB NO: 1219-0025 EXPIRATION DATE: 06/30/2004
RESPS:161 HOURS:90 COSTS(000):$1
Application for a Permit to Fire More than 20 Boreholes for the
use of Nonpermissible Blasting Units, Explosive, and Shot-firing
Units
FORMS: NONE
OMB NO: 1219-0026 EXPIRATION DATE: 09/30/2003
RESPS:159 HOURS:1,404 COSTS(000):$0
Ground Control Plan (30 CFR 77.1000 and 77.1000-1)
FORMS: NONE
OMB NO: 1219-0030 EXPIRATION DATE: 12/31/2003
RESPS:2,625 HOURS:1,313 COSTS(000):$2
Main Fan Operation and Inspection (30 CFR 57.22204)
FORMS: NONE
OMB NO: 1219-0034 EXPIRATION DATE: 03/31/2005
RESPS:276,032 HOURS:136,038 COSTS(000):$209
Records of Tests and Examinations of Personnel Hoisting Equipment
FORMS: NONE
OMB NO: 1219-0067 EXPIRATION DATE: 05/31/2005
RESPS:1,591,866 HOURS:1,011,034 COSTS(000):$30,000
Examinations and Tests of Electrical Equipment (30 CFR 75.512,
75.703(d)(II), 77.502, 75.800, 77.900, 75.1001-1(c), and 75.351)
FORMS: NONE
OMB NO: 1219-0069 EXPIRATION DATE: 05/31/2003
RESPS:611 HOURS:213 COSTS(000):$0
Qualification and Certification Program (30 CFR 75.100; 75.155;
77.100; and 77.105)
FORMS: 5000-4 5000-7
OMB NO: 1219-0070 EXPIRATION DATE: 11/30/2004
RESPS:105,050 HOURS:8,393 COSTS(000):$210
Certificate of Training (30 CFR 48.9 and 48.29)
FORMS: 5000-23
OMB NO: 1219-0073 EXPIRATION DATE: 03/31/2006
RESPS:1,645 HOURS:23,928 COSTS(000):$23,803
Record of Mine Closures, Opening and Reopening of Mines
FORMS: NONE
OMB NO: 1219-0078 EXPIRATION DATE: 01/31/2004
RESPS:46,282 HOURS:24,975 COSTS(000):$468
Mine Rescue Teams; Arrangements for Emergency Medical
Assistance; and Arrangements for Transportation of Injured
Persons
FORMS: 5000-3
OMB NO: 1219-0082 EXPIRATION DATE: 11/30/2003
RESPS:11,858 HOURS:14,823 COSTS(000):$0
Records of Preshift and Onshift Inspections of Slope and Shaft
Areas (30 CFR 77.1901)
FORMS: NONE
OMB NO: 1219-0083 EXPIRATION DATE: 12/31/2003
RESPS:411,885 HOURS:617,828 COSTS(000):$0
Record of Examinations for Hazardous Conditions (30 CFR 77.1713)
FORMS: NONE
OMB NO: 1219-0089 EXPIRATION DATE: 09/30/2004
RESPS:18,203,818 HOURS:1,224,406 COSTS(000):$0
Safety Defects; Examination, Correction and Records (30 CFR
56/57.13015; 13030; 14100; and 56/57.18002)
FORMS: NONE
OMB NO: 1219-0092 EXPIRATION DATE: 04/30/2003
RESPS:2,070 HOURS:259 COSTS(000):$1
Notification of Commencement of Operations and Closing of Mines
(30 CFR 56.1000 and 57.1000)
FORMS: NONE
OMB NO: 1219-0095 EXPIRATION DATE: 12/31/2003
RESPS:7 HOURS:7 COSTS(000):$0
Explosive Materials and Blasting Units (30 CFR 57.22606)
FORMS: NONE
OMB NO: 1219-0097 EXPIRATION DATE: 02/28/2005
RESPS:2 HOURS:24 COSTS(000):$0
Rock Burst Control Plan (Pertains to Underground Metal/Nonmetal
Mines (30 CFR 57.3461)
FORMS: NONE
OMB NO: 1219-0100 EXPIRATION DATE: 08/31/2003
RESPS:307 HOURS:565 COSTS(000):$42
Product Testing by Applicant or Third Part (30 CFR Part 7,
Subparts A through F, and J through K)
FORMS: NONE
OMB NO: 1219-0101 EXPIRATION DATE: 11/30/2003
RESPS:2 HOURS:16 COSTS(000):$0
Applications for Approval of Sanitary Toilet Facilities (30 CFR
71.500 and 75.1712-6)
FORMS: NONE
OMB NO: 1219-0103 EXPIRATION DATE: 08/31/2003
RESPS:372 HOURS:31 COSTS(000):$0
Notification of Methane Detected in Mine Atmosphere (30 CFR
57.220004(c); 57.22229; 57.22230; 57.22231, and 57.22239)
FORMS: NONE
OMB NO: 1219-0119 EXPIRATION DATE: 03/31/2006
RESPS:101,944 HOURS:58,265 COSTS(000):$377
Approval, Exhaust Gas Monitoring, and Safety Requirements for
the Use of Diesel-Powered Equipment in Underground Coal Mines
FORMS: NONE
OMB NO: 1219-0120 EXPIRATION DATE: 01/31/2006
RESPS:821,843 HOURS:101,852 COSTS(000):$4,151
Noise Exposure Assessment; Audometric Testing Evaluaiton, and
Records and Training in All Mines
FORMS: NONE
OMB NO: 1219-0121 EXPIRATION DATE: 08/31/2003
RESPS:8,616 HOURS:431 COSTS(000):$0
Safety Standard for Roof Bolts in Metal and Nonmetal Mines and
Underground Coal Mines (30 CFR 56/57.3203(a), and 75.204(a))
FORMS: NONE
OMB NO: 1219-0124 EXPIRATION DATE: 05/31/2004
RESPS:5,758 HOURS:1,697 COSTS(000):$171
Diesel Particulate Matter Exposure of Underground Coal Miners.
(30 CFR 75.1915, 72.503, 72.510, 72.520, 72.500, Part 7 of Part
36)
FORMS: NONE
OMB NO: 1220-0090 EXPIRATION DATE: 11/30/2005
RESPS:23,848 HOURS:81,547 COSTS(000):$0
Mass Layoff Statistics Program
FORMS: NONE
OMB NO: 1220-0100 EXPIRATION DATE: 08/31/2005
RESPS:684,000 HOURS:79,800 COSTS(000):$0
Current Population Survey (CPS) Basic Labor Force
FORMS: NONE
OMB NO: 1220-0110 EXPIRATION DATE: 12/31/2003
RESPS:7,345 HOURS:7,904 COSTS(000):$0
National Longitudinal Survey of Women
FORMS: NLS-A033 NLS-A033(L) NLS-A035.1 NSL-A035.2 NLS-A037.1 NLS-A037.2
NLS-A0336
OMB NO: 1220-0133 EXPIRATION DATE: 02/28/2005
RESPS:27,500 HOURS:5,000 COSTS(000):$0
Census of Fatal Occupational Injuries
FORMS: BLS-CFOI-1
OMB NO: 1220-0134 EXPIRATION DATE: 02/29/2004
RESPS:459,068 HOURS:169,855 COSTS(000):$0
Multiple Workshie Report and the Report of Federal Employment
and Wages
FORMS: BLS-3020 BLS-3021
OMB NO: 1220-0141 EXPIRATION DATE: 01/31/2006
RESPS:4,000 HOURS:4,000 COSTS(000):$0
Cognitive and Psychological Research
FORMS: NONE
OMB NO: 1225-0080 EXPIRATION DATE: 12/31/2005
RESPS:110 HOURS:588 COSTS(000):$0
Women in Apprenticeship and Nontraditional Occupations (WANTO)
Act Grant Application and Reporting Requirements
FORMS: NONE
OMB NO: 1225-0082 EXPIRATION DATE: 06/30/2003
RESPS:1,000 HOURS:100 COSTS(000):$0
The National Survey of Attitudes Reguarding Comp Time and
Balancing Work and Family
FORMS: NONE
OMB NO: 1225-0083 EXPIRATION DATE: 02/28/2006
RESPS:1,000 HOURS:80 COSTS(000):$0
Survey on Ensuring Equal Opportunity for Applicants
FORMS: NONE
OMB NO: 1230-0002 EXPIRATION DATE: 12/31/2005
RESPS:100 HOURS:1,000 COSTS(000):$0
Solicitation of Nominations for the Department of Labor's New
Freedom Initiative Award
FORMS: NONE
OMB NO: 1405-0003 EXPIRATION DATE: 07/31/2005
RESPS:30,000 HOURS:30,000 COSTS(000):$0
Application/License for permanent export of unclassified defense
articles and related unclassified technical data
FORMS: DSP-5 DSP-5(WEBBASED)
OMB NO: 1405-0008 EXPIRATION DATE: 04/30/2003
RESPS:13,660 HOURS:3,415 COSTS(000):$0
Department of State-Foreign Service Officer Written Examination
Registration
FORMS: DS-1998
OMB NO: 1405-0013 EXPIRATION DATE: 07/31/2005
RESPS:1,000 HOURS:500 COSTS(000):$0
Application/License for temporary import of unclassified defense
articles
FORMS: DSP-61
OMB NO: 1405-0014 EXPIRATION DATE: 12/31/2005
RESPS:75,000 HOURS:6,250 COSTS(000):$0
Statement Regarding A Lost or Stolen Passport
FORMS: DS-64
OMB NO: 1405-0015 EXPIRATION DATE: 05/31/2004
RESPS:750,000 HOURS:1,500,000 COSTS(000):$0
Application for Immigrant Visa and Alien Registration
FORMS: DS-230
OMB NO: 1405-0020 EXPIRATION DATE: 03/31/2005
RESPS:1,462,200 HOURS:365,300 COSTS(000):$125,916
Application for Passport by mail
FORMS: DS-82
OMB NO: 1405-0021 EXPIRATION DATE: 07/31/2005
RESPS:17,000 HOURS:17,000 COSTS(000):$0
Non Transfer and Use Certificate
FORMS: DSP-83
OMB NO: 1405-0022 EXPIRATION DATE: 07/31/2005
RESPS:250 HOURS:250 COSTS(000):$0
Application/License for Permanent/Temporary Export or Temporary
Import of Classified Defense Articles and Classified Technical
Data
FORMS: DSP-85
OMB NO: 1405-0023 EXPIRATION DATE: 07/31/2005
RESPS:2,500 HOURS:2,500 COSTS(000):$0
Application/License for temporary export of unclassified defense
articles
FORMS: DSP-73
OMB NO: 1405-0025 EXPIRATION DATE: 07/31/2005
RESPS:12,000 HOURS:12,000 COSTS(000):$0
Statement of political contributions, fees or commissions in
connection with the sale of defense articles or services
FORMS: NONE
OMB NO: 1405-0031 EXPIRATION DATE: 09/30/2005
RESPS:89 HOURS:45 COSTS(000):$0
Approval of Funding to Support Educational Projects
FORMS: 2061
OMB NO: 1405-0033 EXPIRATION DATE: 01/31/2004
RESPS:190 HOURS:217 COSTS(000):$7
Overseas Schools - Grant Status Report
FORMS: DS-2028
OMB NO: 1405-0050 EXPIRATION DATE: 02/28/2006
RESPS:2,790 HOURS:225,503 COSTS(000):$283
Department of State Acquisition Regulation (DOSAR)
FORMS: NONE
OMB NO: 1405-0051 EXPIRATION DATE: 07/31/2005
RESPS:2,500 HOURS:1,250 COSTS(000):$0
Authority to export defense articles and services sold under the
foreign military sales (FMS) Program
FORMS: DSP-94
OMB NO: 1405-0060 EXPIRATION DATE: 04/30/2003
RESPS:5,000 HOURS:2,125 COSTS(000):$100
Notification of Appointment of Foreign Government Employees
FORMS: DS-2004
OMB NO: 1405-0061 EXPIRATION DATE: 04/30/2003
RESPS:6,000 HOURS:720 COSTS(000):$0
Notification of Termination of Diplomatic, Consular, and Foreign
Government Employees
FORMS: DS-2008
OMB NO: 1405-0062 EXPIRATION DATE: 04/30/2003
RESPS:2,000 HOURS:850 COSTS(000):$40
Notification of Appointment of Foreign Diplomatic Officer and
Career Consular Officer
FORMS: DS-2003
OMB NO: 1405-0064 EXPIRATION DATE: 04/30/2003
RESPS:200 HOURS:80 COSTS(000):$4
Notification of Appointment of Honorary Consular Officer
FORMS: DS-2005
OMB NO: 1405-0068 EXPIRATION DATE: 09/30/2005
RESPS:12,000 HOURS:12,000 COSTS(000):$0
Medical History and Examination for Foreign Service-For persons
12 years and over Medical History and Examination for Foreign
Service-For children 11 years under
FORMS: DS-1843 DS-1622
OMB NO: 1405-0069 EXPIRATION DATE: 12/31/2005
RESPS:2,916 HOURS:49 COSTS(000):$0
Application for Diplomatic Exemption from Taxes on Utilities
Application for Diplomatic Exemption from Taxes on Gasoline
FORMS: DS-98 DS-99
OMB NO: 1405-0076 EXPIRATION DATE: 10/31/2003
RESPS:500 HOURS:500 COSTS(000):$0
Application for Assistance Under the Hague Convention on Child
Abduction
FORMS: DS-3013
OMB NO: 1405-0082 EXPIRATION DATE: 05/31/2003
RESPS:500 HOURS:250 COSTS(000):$0
Petition to Classify Special Immigrant Under INA 203(b)(4) as an
employee or former employee of the U.S. Government
FORMS: DS-1884
OMB NO: 1405-0090 EXPIRATION DATE: 04/30/2003
RESPS:7,000 HOURS:840 COSTS(000):$140
Notification of Dependents of Diplomatic, Consular, and Foreign
Government Employees (Continuation Sheet)
FORMS: DS-2007
OMB NO: 1405-0091 EXPIRATION DATE: 05/31/2004
RESPS:1,000 HOURS:500 COSTS(000):$0
Application to Determine Returning Resident Status
FORMS: DS-117
OMB NO: 1405-0092 EXPIRATION DATE: 07/31/2005
RESPS:9,000 HOURS:4,500 COSTS(000):$0
Application for amendment to license for export or import of
classified or unclassified defense articles and related
technical data
FORMS: DSP-119
OMB NO: 1405-0093 EXPIRATION DATE: 07/31/2005
RESPS:5,000 HOURS:10,000 COSTS(000):$0
Request for approval of manufacturing license agreements,
technical assistance agreements and other agreements
FORMS: NONE
OMB NO: 1405-0098 EXPIRATION DATE: 06/30/2003
RESPS:90,000 HOURS:45,000 COSTS(000):$0
Supplemental Registration for the Diversity Immigrant Visa
Program
FORMS: DSP-122
OMB NO: 1405-0100 EXPIRATION DATE: 06/30/2003
RESPS:20,000 HOURS:10,000 COSTS(000):$0
Application for A, G, or NATO Visa
FORMS: DS-1648
OMB NO: 1405-0104 EXPIRATION DATE: 02/28/2005
RESPS:13,200 HOURS:3,072 COSTS(000):$0
Request for Customs Clearance of Merchandise
FORMS: DS-1504
OMB NO: 1405-0105 EXPIRATION DATE: 04/30/2005
RESPS:12,500 HOURS:6,250 COSTS(000):$0
United States Department of State Driver License and Tax
Exemption Card Application
FORMS: DS-1972
OMB NO: 1405-0111 EXPIRATION DATE: 07/31/2005
RESPS:5,000 HOURS:100,000 COSTS(000):$1,500
"Maintenance of records by registrants" Section 122.5 of the
International Traffic in Arms Regulations (ITAR)
FORMS: NONE
OMB NO: 1405-0113 EXPIRATION DATE: 01/31/2004
RESPS:700,000 HOURS:1,400,000 COSTS(000):$70,000
Medical Examination of Applicants for United States Visas
FORMS: DS-2053 DS-3024 DS-3025 DS-3026
OMB NO: 1405-0114 EXPIRATION DATE: 09/30/2005
RESPS:862 HOURS:1,724 COSTS(000):$0
Fulbright Teacher and Administrator Exchange Program Application
OMB#1405-0114 U.S. Department of State, Bureau of Education and
Cultural Affairs
FORMS: 4500 4501 4502 4503 4504 4505 4506
OMB NO: 1405-0118 EXPIRATION DATE: 02/28/2005
RESPS:3,877 HOURS:1,938 COSTS(000):$0
Evaluation of DOS-sponsored Educational and Cultural Exchange
Programs (formerly, USIA-sponsored Educational and Cultural
Exchange Activities; USIA Program Participant Survey
FORMS: NONE
OMB NO: 1405-0119 EXPIRATION DATE: 02/28/2005
RESPS:300,000 HOURS:225,000 COSTS(000):$5,625
Certificate of Eligibility for Exchange Visitor (J-1) Status
FORMS: DS-2019
OMB NO: 1405-0124 EXPIRATION DATE: 08/31/2003
RESPS:20,200 HOURS:12,400 COSTS(000):$0
Irish Peace Process Cultural and Training Program (IPPCTP)
Employer Information Collection
FORMS: NONE
OMB NO: 1405-0126 EXPIRATION DATE: 10/31/2003
RESPS:350,000 HOURS:175,000 COSTS(000):$0
Choice of Address and Agent for US Department of State Immigrant
Visa Applicants
FORMS: NONE
OMB NO: 1405-0128 EXPIRATION DATE: 06/30/2003
RESPS:100,000 HOURS:100,000 COSTS(000):$0
Nonimmigrant V Visa Application
FORMS: DS-3052
OMB NO: 1405-0129 EXPIRATION DATE: 03/31/2005
RESPS:1,300,000 HOURS:108,300 COSTS(000):$0
Statement of Consent: Issuance of a passport to a minor under
the age of 14
FORMS: DS-3053
OMB NO: 1405-0139 EXPIRATION DATE: 05/31/2005
RESPS:25,000 HOURS:12,500 COSTS(000):$0
U.S. Department of State, Application for Employment, DS-1950
FORMS: DS-1950
OMB NO: 1405-0143 EXPIRATION DATE: 05/31/2005
RESPS:250 HOURS:3,750 COSTS(000):$0
Thomas R. Pickering Foreign Affairs Fellowship Program
FORMS: DS-3091
OMB NO: 1405-0144 EXPIRATION DATE: 04/30/2003
RESPS:2,500,000 HOURS:2,500,000 COSTS(000):$0
Contact Information and Work History For Nonimmigrant Visa
Applicant
FORMS: DS-158
OMB NO: 1405-0145 EXPIRATION DATE: 09/30/2005
RESPS:200 HOURS:100 COSTS(000):$54
Training Registration Form (For Non-US Government Persons)
FORMS: 3083
OMB NO: 1405-0146 EXPIRATION DATE: 12/31/2005
RESPS:20,000 HOURS:1,667 COSTS(000):$0
Statement of Non-Receipt of a Passport
FORMS: DS-86
OMB NO: 2100-0019 EXPIRATION DATE: 06/30/2005
RESPS:3,448 HOURS:316,226 COSTS(000):$0
American with Disabilities; Information Collection Requirements
for Final Rule on Over-the-Road Buses
FORMS: NONE
OMB NO: 2105-0508 EXPIRATION DATE: 09/30/2004
RESPS:1,460 HOURS:29,043 COSTS(000):$0
Uniform Relocation Assistance and Real Property Acquisition
Regulations for Federal and Federally Assisted Programs
FORMS: NONE
OMB NO: 2105-0510 EXPIRATION DATE: 04/30/2003
RESPS:1,798 HOURS:1,456,683 COSTS(000):$0
Report of DBE Awards and Commitments
FORMS: DOT-F4630
OMB NO: 2105-0520 EXPIRATION DATE: 10/31/2004
RESPS:7,180 HOURS:125,650 COSTS(000):$0
Uniform Administrative Requirements for Grants and Cooperative
Agreements to State and Local Governments
FORMS: 269 270 271 272 424
OMB NO: 2105-0529 EXPIRATION DATE: 01/31/2004
RESPS:8,475,340 HOURS:842,478 COSTS(000):$0
Procedures for Transportation Drug and Alcohol Testing Program
FORMS: NONE
OMB NO: 2105-0531 EXPIRATION DATE: 08/31/2004
RESPS:600 HOURS:10,500 COSTS(000):$0
Uniform Administrative Requirements for Grants and Agreements
with Institutions of Higher Education, Hospitals and Other Non-
Profit Organizations
FORMS: NONE
OMB NO: 2106-0005 EXPIRATION DATE: 01/31/2006
RESPS:1,738 HOURS:1,343 COSTS(000):$0
Public Charter-14 CFR Part 380
FORMS: 4532 4533 4534 4535
OMB NO: 2106-0009 EXPIRATION DATE: 09/30/2005
RESPS:3,068,200 HOURS:650,000 COSTS(000):$0
14 CFR Part 221 - Construction, Publication, Filing and Posting
of Tariffs of Air Carriers and Foreign Air Carriers
FORMS: NONE
OMB NO: 2106-0023 EXPIRATION DATE: 11/30/2003
RESPS:127 HOURS:4,604 COSTS(000):$0
Procedures & Evidence rules for Air Carrier Authority
Applications
FORMS: NONE
OMB NO: 2106-0043 EXPIRATION DATE: 09/30/2003
RESPS:15 HOURS:69 COSTS(000):$0
Use and Change of Names of Air Carriers, Foreign Air Carriers,
and Commuter Air Carriers
FORMS: NONE
OMB NO: 2120-0001 EXPIRATION DATE: 05/31/2004
RESPS:53,000 HOURS:15,500 COSTS(000):$0
Notice of Proposed Construction or Alteration, Notice of Actual
Construction or Alteration, & Project Status Report
FORMS: FORM-7460-1 FORM-7460-2
OMB NO: 2120-0026 EXPIRATION DATE: 04/30/2003
RESPS:17,584,302 HOURS:293,072 COSTS(000):$0
Domestic and International Flight Plan Forms
FORMS: 7233-1 7233-4
OMB NO: 2120-0027 EXPIRATION DATE: 06/30/2005
RESPS:25,231 HOURS:12,202 COSTS(000):$0
Application for Certificate of Waiver or Authorization
FORMS: 7711-2
OMB NO: 2120-0033 EXPIRATION DATE: 12/31/2003
RESPS:4,840 HOURS:3,974 COSTS(000):$0
Representatives of the Administrator, FAR 183
FORMS: FAA-8110-14 FAA-8110-28 FAA-8710-9 FAA-8110-10
OMB NO: 2120-0034 EXPIRATION DATE: 11/30/2004
RESPS:483,554 HOURS:707,253 COSTS(000):$0
Medical Standards and Certification (14 CFR part 67) Duration of
Medical Certificates (14 CFR part 61)
FORMS: 8500-7 8500-8 8500-14 8500-20
OMB NO: 2120-0036 EXPIRATION DATE: 01/31/2004
RESPS:3,868 HOURS:2,901 COSTS(000):$0
Notice of Landing Area Proposal
FORMS: FAA/7480-1
OMB NO: 2120-0507 EXPIRATION DATE: 06/30/2005
RESPS:39 HOURS:326 COSTS(000):$0
Special Federal Aviation Regulation (SFAR) 36, development of
Major Repair Data
FORMS: 8100-8
OMB NO: 2120-0524 EXPIRATION DATE: 09/30/2004
RESPS:2,742 HOURS:3,064 COSTS(000):$0
High Density Traffic Airports; Slot Allocation and Transfer
Methods
FORMS: NONE
OMB NO: 2120-0535 EXPIRATION DATE: 12/31/2005
RESPS:251,729 HOURS:26,373 COSTS(000):$0
Antidrug and Alcohol Misuse Prevention Programs for Personnel
Engaged in Specified Aviation Activities
FORMS: 9000-2 9000-3
OMB NO: 2120-0539 EXPIRATION DATE: 01/31/2005
RESPS:15 HOURS:600 COSTS(000):$0
Implementation of the Equal Access to Justice Act
FORMS: NONE
OMB NO: 2120-0543 EXPIRATION DATE: 01/31/2006
RESPS:2,184 HOURS:364 COSTS(000):$0
Pilots Convicted of Alcohol or Drug-Related Motor Vehicle
Offenses or Subject to State Motor Vehicle Administrative
Procedures.
FORMS: 8500-8
OMB NO: 2120-0593 EXPIRATION DATE: 12/31/2004
RESPS:1,702 HOURS:8,855 COSTS(000):$0
Part 119-Certification: Air Carrier and Commercial Operators
FORMS: FORM-8400-6
OMB NO: 2120-0595 EXPIRATION DATE: 05/31/2005
RESPS:264,718 HOURS:1,701,099 COSTS(000):$0
Federal Aviation Administration Acquisition Management System
(FAAAMS)
FORMS: NONE
OMB NO: 2120-0597 EXPIRATION DATE: 04/30/2003
RESPS:50,000 HOURS:75,000 COSTS(000):$0
Application for Employment with the Federal Aviation
Administration
FORMS: 3330.76
OMB NO: 2120-0600 EXPIRATION DATE: 12/31/2005
RESPS:3,000 HOURS:13 COSTS(000):$0
Training and Qualification Requirements for Check Airmen and
Flight Instructors
FORMS: NONE
OMB NO: 2120-0601 EXPIRATION DATE: 08/31/2005
RESPS:5 HOURS:1,305 COSTS(000):$0
Commercial Space Transportation Financial Responsibility for
Licensed Launch Activities
FORMS: NONE
OMB NO: 2120-0604 EXPIRATION DATE: 12/31/2005
RESPS:450 HOURS:225 COSTS(000):$0
Aviation Medical Examiner Program
FORMS: 8520-2
OMB NO: 2120-0611 EXPIRATION DATE: 11/30/2003
RESPS:300 HOURS:300 COSTS(000):$0
Associate Administrator for Commercial Space Transportation
(AST) Customer Service Survey
FORMS: NONE
OMB NO: 2120-0614 EXPIRATION DATE: 08/31/2003
RESPS:360 HOURS:720 COSTS(000):$0
Revised Standards for Cargo or Baggage Compartments in Transport
Category Airplanes
FORMS: NONE
OMB NO: 2120-0616 EXPIRATION DATE: 08/31/2003
RESPS:2,960 HOURS:1 COSTS(000):$54,600
Revisions to Digital Flight Data Recorders
FORMS: NONE
OMB NO: 2120-0618 EXPIRATION DATE: 12/31/2003
RESPS:600 HOURS:50 COSTS(000):$0
Overflight Billing and Collection Customer Information Form
FORMS: NONE
OMB NO: 2120-0620 EXPIRATION DATE: 01/31/2004
RESPS:100,000 HOURS:6,667 COSTS(000):$0
Special Federal Aviation Regulation No. 71
FORMS: NONE
OMB NO: 2120-0631 EXPIRATION DATE: 07/31/2004
RESPS:1 HOURS:1 COSTS(000):$140,000
Terrain Awareness and Warning System (TAWS)
FORMS: NONE
OMB NO: 2120-0632 EXPIRATION DATE: 01/31/2005
RESPS:40 HOURS:820 COSTS(000):$0
Office of Dispute Resolution Procedures for Protests and
Contract Disputes, 14 CFR part 17
FORMS: NONE
OMB NO: 2120-0633 EXPIRATION DATE: 09/30/2005
RESPS:2,059 HOURS:1,026 COSTS(000):$0
Exemptions for Air Taxi and Commuter Air Carrier Operations
FORMS: OST-FORM-4507
OMB NO: 2120-0644 EXPIRATION DATE: 07/31/2005
RESPS:2 HOURS:1,592 COSTS(000):$0
Commercial Space Transportation Licensing Requirements for
Operation of a Launch Site
FORMS: NONE
OMB NO: 2120-0646 EXPIRATION DATE: 08/31/2005
RESPS:5 HOURS:5 COSTS(000):$0
Protection of Voluntarily Submitted Information
FORMS: NONE
OMB NO: 2120-0648 EXPIRATION DATE: 11/30/2005
RESPS:82 HOURS:4,679 COSTS(000):$0
Part 65, Certification: Airmen Other Than Flight Crewmembers,
Subpart C, Aircraft Dispatchers and Appendix A, Aircraft
Dispatcher Courses
FORMS: NONE
OMB NO: 2120-0653 EXPIRATION DATE: 01/31/2006
RESPS:81 HOURS:86 COSTS(000):$0
Part 93, Subpart U-Special Flight Rules in the Vicinity of Grand
Canyon National Park, AZ (formerly titled Commercial Air Tour
Limitation in the Grand Canyon National Park Special Flight Rules
FORMS: NONE
OMB NO: 2120-0657 EXPIRATION DATE: 09/30/2003
RESPS:2,558 HOURS:18,815 COSTS(000):$0
Type Certification Procedures for Changed Products
FORMS: NONE
OMB NO: 2120-0659 EXPIRATION DATE: 09/30/2003
RESPS:10 HOURS:1,350 COSTS(000):$0
Noise Certification Standards for Subsonic Jet Airplanes and
Subsonic Transport Category Large Airplanes
FORMS: NONE
OMB NO: 2120-0672 EXPIRATION DATE: 12/31/2004
RESPS:10 HOURS:5,680 COSTS(000):$0
Criteria for internet communications of aviation weather, notam
and aeronautical data
FORMS: NONE
OMB NO: 2120-0674 EXPIRATION DATE: 05/31/2005
RESPS:49 HOURS:2,352 COSTS(000):$0
Special Federal Aviation Regulation (SFAR) 92, Flightcrew
Compartment Access and Door Designs
FORMS: NONE
OMB NO: 2120-0675 EXPIRATION DATE: 02/28/2005
RESPS:2,269 HOURS:52,993 COSTS(000):$0
Certification of Airports, 14 CFR Part 139 (Final Rule)
FORMS: 5281-1
OMB NO: 2120-0677 EXPIRATION DATE: 09/30/2005
RESPS:89,450 HOURS:8,269 COSTS(000):$0
Enhanced Security Procedures at Certain Airports, Washington DC
Area
FORMS: NONE
OMB NO: 2120-0680 EXPIRATION DATE: 09/30/2005
RESPS:450 HOURS:201,653 COSTS(000):$0
Part 60-Flight Simulation Device Initial and Continuing
Qualification and Use (NPRM)
FORMS: NONE
OMB NO: 2120-0682 EXPIRATION DATE: 12/31/2005
RESPS:19,497 HOURS:270,239 COSTS(000):$0
New Final Rule Certification of Repair Stations, Part 145 of
Title 14, CFR
FORMS: 8310-3
OMB NO: 2120-0683 EXPIRATION DATE: 01/31/2006
RESPS:174 HOURS:1,218 COSTS(000):$0
National Parks Air Tour Management, 14 CFR Part 136
FORMS: NONE
OMB NO: 2125-0033 EXPIRATION DATE: 12/31/2003
RESPS:1,300 HOURS:8,450 COSTS(000):$0
Statement of Materials and Labor used by Contractors on Highway
Construction involving Federal Funds
FORMS: FHWA-47
OMB NO: 2125-0034 EXPIRATION DATE: 05/31/2003
RESPS:104 HOURS:4,160 COSTS(000):$0
Certification of Enforcement of Vehicle Size and Weight Laws
FORMS: NONE
OMB NO: 2125-0039 EXPIRATION DATE: 04/30/2004
RESPS:52 HOURS:29,120 COSTS(000):$0
Planning and Research Program Administration
FORMS: NONE
OMB NO: 2125-0529 EXPIRATION DATE: 06/30/2004
RESPS:12,040 HOURS:12,040 COSTS(000):$0
Preparation and Execution of the Project Agreement and
Modifications
FORMS: NONE
OMB NO: 2125-0541 EXPIRATION DATE: 08/31/2004
RESPS:51 HOURS:612 COSTS(000):$0
Certification of Enforcement of Heavy Vehicle Use Tax
FORMS: NONE
OMB NO: 2125-0591 EXPIRATION DATE: 08/31/2003
RESPS:675 HOURS:338 COSTS(000):$0
Environmental Streamlining Measuring the Performance of
Stakeholders in the Transportation Project Development Process
FORMS: NONE
OMB NO: 2126-0008 EXPIRATION DATE: 06/30/2003
RESPS:118,590 HOURS:5,285 COSTS(000):$0
Financial Responsibility for Motor Carriers of Passengers and
Motor Carriers of Property
FORMS: MCS-90 MCS-90B MCS-82 MCS-82B
OMB NO: 2126-0018 EXPIRATION DATE: 04/30/2004
RESPS:1,000 HOURS:250 COSTS(000):$0
Request for Revocation of Authority Granted
FORMS: OCE-46
OMB NO: 2126-0019 EXPIRATION DATE: 03/31/2005
RESPS:7,218 HOURS:23,818 COSTS(000):$307
Application for Certificate of Registration for Foreign Motor
Carriers and Foreign Motor Private Carriers
FORMS: OP-2
OMB NO: 2127-0003 EXPIRATION DATE: 03/31/2005
RESPS:1,140 HOURS:570 COSTS(000):$0
23 CFR Parts Uniform Safety Program Cost Summary Form for
Highway Safety Plan
FORMS: FORM-217
OMB NO: 2127-0021 EXPIRATION DATE: 05/31/2003
RESPS:13,500 HOURS:5,807 COSTS(000):$0
National Automotive Sampling System (NASS) Crashworthiness Data
Systems (CDS)
FORMS: HS-433A HS-433B HS-435H HS-435I
OMB NO: 2127-0025 EXPIRATION DATE: 02/28/2005
RESPS:266 HOURS:1,064 COSTS(000):$0
49 CFR Part 512, Confidential Business Information
FORMS: NONE
OMB NO: 2127-0038 EXPIRATION DATE: 11/30/2004
RESPS:23 HOURS:11 COSTS(000):$0
Assigning DOT Code Numbers to Glazing Material Manufacturers
FORMS: NONE
OMB NO: 2127-0039 EXPIRATION DATE: 02/28/2005
RESPS:21 HOURS:21 COSTS(000):$0
49 CFR Part 557, Petitions for Hearings on Notification and
Remedy of Defects.
FORMS: NONE
OMB NO: 2127-0044 EXPIRATION DATE: 02/28/2005
RESPS:14,250,000 HOURS:950,000 COSTS(000):$467
Names and Addresses of First Purchasers of Motor Vehicles
FORMS: NONE
OMB NO: 2127-0521 EXPIRATION DATE: 07/31/2004
RESPS:70,000,000 HOURS:7,000 COSTS(000):$81
49 CFR Part 571.116 Motor Vehicle Brake Fluids
FORMS: NONE
OMB NO: 2127-0539 EXPIRATION DATE: 11/30/2004
RESPS:40 HOURS:640 COSTS(000):$0
49 CFR Part 542, Procedures for Selecting Lines To Be Covered by
the Theft Prevention Standard
FORMS: NONE
OMB NO: 2127-0541 EXPIRATION DATE: 12/31/2005
RESPS:204 HOURS:1,771 COSTS(000):$3,887
Consolidated Justification of Owner's Manual Requirements for
Vehicle Equipment
FORMS: NONE
OMB NO: 2127-0542 EXPIRATION DATE: 11/30/2004
RESPS:4 HOURS:64 COSTS(000):$0
49 CFR Part 543, Exemption from Vehicle Theft Prevention Standard
FORMS: NONE
OMB NO: 2127-0547 EXPIRATION DATE: 08/31/2003
RESPS:46 HOURS:68,325 COSTS(000):$2,010
Part 544 - Insurer Reporting Requirements -- Motor Vechicle
Theft Law Enforcement Act of 1984
FORMS: NONE
OMB NO: 2127-0588 EXPIRATION DATE: 01/31/2004
RESPS:15,000 HOURS:7,500 COSTS(000):$5
Air Bag Deactivation
FORMS: HS-FORM-603 DOT-HS-808-629
OMB NO: 2127-0597 EXPIRATION DATE: 03/31/2005
RESPS:52 HOURS:17,942 COSTS(000):$0
Uniform criteria for State observational surveys of seat belt use
FORMS: NONE
OMB NO: 2127-0599 EXPIRATION DATE: 03/31/2005
RESPS:21 HOURS:1,260 COSTS(000):$0
Part 585 - Advanced Air Bag Phase-In Reporting Requirements
FORMS: NONE
OMB NO: 2127-0600 EXPIRATION DATE: 03/31/2005
RESPS:56 HOURS:1,736 COSTS(000):$0
23 Part 1345 Occupant Protection Incentive Grant Section 405
FORMS: HS-217
OMB NO: 2127-0606 EXPIRATION DATE: 06/30/2003
RESPS:57 HOURS:114 COSTS(000):$0
23 CFR Part 1335-State Highway Safety Data and Traffice Records
Improvements
FORMS: NONE
OMB NO: 2127-0610 EXPIRATION DATE: 07/31/2004
RESPS:9 HOURS:4 COSTS(000):$0
Reporting of Sale or Lease of Defective or Noncompliant Tires
FORMS: NONE
OMB NO: 2127-0612 EXPIRATION DATE: 10/31/2004
RESPS:5,600 HOURS:1,680 COSTS(000):$0
National Survey of Drinking and Driving Attitudes & Behaviors -
2001
FORMS: NONE
OMB NO: 2127-0613 EXPIRATION DATE: 11/30/2004
RESPS:4,000 HOURS:1,000 COSTS(000):$0
National Survey of Speeding, Driving While Distracted and other
Unsafe Driving Behaviors
FORMS: NONE
OMB NO: 2127-0614 EXPIRATION DATE: 04/30/2005
RESPS:7,500 HOURS:4,373 COSTS(000):$0
Highway Crash Data Collection for Evaluation of Antilock Braking
Systems (ABS) & Rear Impact Guards
FORMS: NONE
OMB NO: 2127-0615 EXPIRATION DATE: 12/31/2004
RESPS:54,800 HOURS:9,133 COSTS(000):$0
Buckle Up America Telephone Surveys 2002-2004
FORMS: NONE
OMB NO: 2127-0616 EXPIRATION DATE: 12/31/2005
RESPS:444 HOURS:240,284 COSTS(000):$70,369
Reporting of Information and Documents about Potential Defects-
Retention of Records 49 CFR Part 579
FORMS: NONE
OMB NO: 2127-0620 EXPIRATION DATE: 12/31/2005
RESPS:500 HOURS:2,060 COSTS(000):$0
Reporting of Information About Foreign Safety Recalls and
Campaigns Related to Potential Defects
FORMS: NONE
OMB NO: 2127-0621 EXPIRATION DATE: 12/31/2005
RESPS:10 HOURS:144 COSTS(000):$0
FMVSS 571.403 Platform Lift Systems for Motor vehicles. FMVSS
571.404 Platform Lift installation in Motor Vehicles.
FORMS: NONE
OMB NO: 2127-0623 EXPIRATION DATE: 06/30/2003
RESPS:27 HOURS:2,700 COSTS(000):$0
Tire Pressure Reserve and Tire Failure Data Special Order
FORMS: NONE
OMB NO: 2127-0624 EXPIRATION DATE: 10/31/2003
RESPS:840 HOURS:420 COSTS(000):$0
Heavy Vehicle Antilock Braking System and Underride Guard Fleet
Maintenance Study
FORMS: NONE
OMB NO: 2127-0626 EXPIRATION DATE: 09/30/2003
RESPS:12,000 HOURS:3,000 COSTS(000):$0
National Automotive Sampling System Tire Pressure Monitoring
System Study (TPMSS)
FORMS: NONE
OMB NO: 2130-0005 EXPIRATION DATE: 09/30/2003
RESPS:27,431,566 HOURS:4,067,432 COSTS(000):$1
Hours of Service Regulations
FORMS: FRA-F-6180.3
OMB NO: 2130-0006 EXPIRATION DATE: 07/31/2003
RESPS:1,673,786 HOURS:480,326 COSTS(000):$5
Railroad Signal System Requirements
FORMS: FRA-F-6180.14 FRA-F-6180.47
OMB NO: 2130-0008 EXPIRATION DATE: 12/31/2003
RESPS:12,013,516,275 HOURS:696,174 COSTS(000):$9,438
Inspection Brake System Safety Standards for Freight and Other
FORMS: NONE
OMB NO: 2130-0526 EXPIRATION DATE: 06/30/2003
RESPS:360,124 HOURS:129,916 COSTS(000):$56
Control of Alcohol and Drug Use in Railroad Operations
FORMS: FRA-F-6180.73 6180.74 6180-94A 6180.94B
OMB NO: 2130-0555 EXPIRATION DATE: 01/31/2005
RESPS:417 HOURS:622 COSTS(000):$2
Foreign Railroads Foreign-Based (FRFB) Employees Who Perform
Train or Dispatching Service in the United States
FORMS: NONE
OMB NO: 2130-0556 EXPIRATION DATE: 01/31/2006
RESPS:8 HOURS:36 COSTS(000):$0
U. S. Locational Requirement for Dispatching U.S. Rail Operations
FORMS: NONE
OMB NO: 2132-0500 EXPIRATION DATE: 05/31/2004
RESPS:111 HOURS:6,540 COSTS(000):$0
49 U.S.C. Section 5310-Capital Assistance Program for Elderly
Persons and Persons with Disabilities and Section 5311-
Nonurbanized Area Formula Program
FORMS: NONE
OMB NO: 2132-0502 EXPIRATION DATE: 12/31/2004
RESPS:198,466 HOURS:198,466 COSTS(000):$0
49 U.S.C. Section 5309 Capital Program and Section 5307
Urbanized Area Formula Progrm
FORMS: NONE
OMB NO: 2132-0556 EXPIRATION DATE: 09/30/2003
RESPS:87,568 HOURS:10,113 COSTS(000):$0
Prevention of Prohibited Drug Use & Control of Alcohol Misuse in
Transit Operations (Was 2 separate information collections:
2132-0556 Prevention of Prohibited Drug Use in Transit Operations
FORMS: NONE
OMB NO: 2133-0006 EXPIRATION DATE: 07/31/2003
RESPS:100 HOURS:200 COSTS(000):$0
Request for Transfer of Ownership, Registry, and Flag, or
Charter, Lease, or Mortgage of U.S. Citizen Owned Documented
Vessels
FORMS: MA-29 MA-29A MA-29B
OMB NO: 2133-0032 EXPIRATION DATE: 08/31/2005
RESPS:21 HOURS:189 COSTS(000):$0
Application for Construction Reserve Fund and Annual Statements
(CRF)
FORMS: NONE
OMB NO: 2133-0503 EXPIRATION DATE: 02/28/2006
RESPS:22 HOURS:66 COSTS(000):$0
Inventory of American Intermodal Equipment
FORMS: NONE
OMB NO: 2133-0504 EXPIRATION DATE: 04/30/2005
RESPS:60 HOURS:60 COSTS(000):$0
Regulations for Making Excess or Surplus Federal Property
Available to the U.S. Merchant Marine Academy State Maritime
Academies
FORMS: NONE
OMB NO: 2133-0509 EXPIRATION DATE: 03/31/2006
RESPS:2,300 HOURS:1,150 COSTS(000):$0
Maritime Administration Service Obligation Compliance Report and
Merchant Marine Reserve US Naval Reserve (USNR) Annual Report
FORMS: MA-930
OMB NO: 2133-0510 EXPIRATION DATE: 04/30/2005
RESPS:61 HOURS:21 COSTS(000):$0
Request for Waiver of Service Obligation; Request for Deferment
of Service Obligation; Application for Review
FORMS: MA-935 MA-936 MA-937
OMB NO: 2133-0514 EXPIRATION DATE: 03/31/2006
RESPS:175 HOURS:700 COSTS(000):$0
Determination of Fair and Reasonable Rates for Carriage of
Agricltural Cargoes on U.S. Commercial Vessels
FORMS: MA-1025 MA-1026 MA-172
OMB NO: 2133-0517 EXPIRATION DATE: 03/31/2006
RESPS:62 HOURS:46 COSTS(000):$0
Approval of Underwriters for Marine Hull Insurance
FORMS: NONE
OMB NO: 2133-0521 EXPIRATION DATE: 03/31/2005
RESPS:1 HOURS:1 COSTS(000):$0
Part 380, Subpart B-Application for Designation of Vessels as
American Great Lakes Vessels
FORMS: NONE
OMB NO: 2133-0524 EXPIRATION DATE: 01/31/2004
RESPS:30 HOURS:1,280 COSTS(000):$0
Port Facility Conveyance Information
FORMS: NONE
OMB NO: 2133-0525 EXPIRATION DATE: 07/31/2005
RESPS:132 HOURS:152 COSTS(000):$0
Application and Reporting Elements for participation in the
Martime Security Program, under Subtitle B, Title VI, Merchant
Marine Act, 1936
FORMS: NONE
OMB NO: 2133-0526 EXPIRATION DATE: 03/31/2006
RESPS:50 HOURS:50 COSTS(000):$0
Information to Determine Seamen's Reemployment Rights - National
Emergency
FORMS: NONE
OMB NO: 2133-0529 EXPIRATION DATE: 11/30/2005
RESPS:100 HOURS:100 COSTS(000):$0
Application for Waiver of the Coastwise Trade Laws for Small
Passenger Vessels
FORMS: NONE
OMB NO: 2133-0530 EXPIRATION DATE: 03/31/2006
RESPS:500 HOURS:2,950 COSTS(000):$0
Eligibility of U.S.-flag Vessels 100 feet or Greater in
Registered Length to Obtain a Fishery Endorsement to the
Vessel's Documentation
FORMS: NONE
OMB NO: 2137-0559 EXPIRATION DATE: 08/31/2003
RESPS:16,640 HOURS:2,759 COSTS(000):$0
(Rail Carriers and Tank Car Tank Requirements) Requirements for
Rail Tank Car Tanks--Transportation of Hazardous Materials by
Rail
FORMS: NONE
OMB NO: 2137-0578 EXPIRATION DATE: 06/30/2004
RESPS:47 HOURS:282 COSTS(000):$0
Reporting on Safety Related Conditions on Gas Hazardous Liquid
Pipelines and LNG Facilities
FORMS: NONE
OMB NO: 2137-0579 EXPIRATION DATE: 05/31/2004
RESPS:2,419 HOURS:2,963 COSTS(000):$0
Drug and Alcohol Testing of Pipeline Operators
FORMS: NONE
OMB NO: 2137-0584 EXPIRATION DATE: 04/30/2005
RESPS:61 HOURS:3,660 COSTS(000):$0
Certification and Agreement Forms for the Gas and Hazardous
Liquid Pipeline Safety Program
FORMS: NONE
OMB NO: 2137-0586 EXPIRATION DATE: 09/30/2004
RESPS:1 HOURS:4,080 COSTS(000):$0
Hazardous Materials Public Sector Training and Planning Grants
FORMS: NONE
OMB NO: 2137-0595 EXPIRATION DATE: 10/31/2004
RESPS:920,530 HOURS:200,615 COSTS(000):$0
Cargo Tank Motor Vehicles in Liquefied Compressed Gas Service
FORMS: NONE
OMB NO: 2137-0598 EXPIRATION DATE: 04/30/2004
RESPS:50 HOURS:100 COSTS(000):$0
Incorporation by Reference of Industry Standard on Leak Detection
FORMS: NONE
OMB NO: 2137-0604 EXPIRATION DATE: 12/31/2003
RESPS:66 HOURS:245,980 COSTS(000):$0
Pipeline Integrity Management in High Consequence Areas
FORMS: NONE
OMB NO: 2137-0605 EXPIRATION DATE: 04/30/2005
RESPS:132 HOURS:501,000 COSTS(000):$0
Pipeline Integrity Management in High Consequence Areas less
than 500 miles
FORMS: NONE
OMB NO: 2137-0610 EXPIRATION DATE: 03/31/2006
RESPS:1 HOURS:2,845,724 COSTS(000):$0
Pipeline Integrity Management in High Consequence Areas Gas
Transmission Pipeline Operators
FORMS: NONE
OMB NO: 2138-0004 EXPIRATION DATE: 11/30/2005
RESPS:75 HOURS:20 COSTS(000):$0
Submission of Audit Reports, Part 248
FORMS: NONE
OMB NO: 2138-0006 EXPIRATION DATE: 06/30/2003
RESPS:482 HOURS:710 COSTS(000):$55
Part 249 Preservation of Records
FORMS: NONE
OMB NO: 2138-0009 EXPIRATION DATE: 06/30/2005
RESPS:1,512 HOURS:1,720 COSTS(000):$25
Form 298-C Report of Financial and Operating Statistics for
Small Aircraft Operators
FORMS: 298-C
OMB NO: 2138-0013 EXPIRATION DATE: 06/30/2005
RESPS:8,000 HOURS:24,428 COSTS(000):$0
Report of Financial and Operating Statistics for Large
Certificated Air Carriers
FORMS: FORM-41
OMB NO: 2138-0016 EXPIRATION DATE: 06/30/2003
RESPS:24 HOURS:24 COSTS(000):$600
Report of Extension of Credit to Political Candidates
FORMS: FORM-183
OMB NO: 2138-0018 EXPIRATION DATE: 01/31/2004
RESPS:560 HOURS:2,200 COSTS(000):$0
Form 251 Report of Passengers Denied Confirmed Space
FORMS: BTS-FORM-251
OMB NO: 2138-0039 EXPIRATION DATE: 11/30/2005
RESPS:40 HOURS:26 COSTS(000):$0
Reporting Required for International Civil Aviation Organization
FORMS: NONE
OMB NO: 2138-0040 EXPIRATION DATE: 07/31/2005
RESPS:3,972 HOURS:24,180 COSTS(000):$90
Report of Traffic and Capacity Statistic-The T-100 System
FORMS: T-100 T-100(F)
OMB NO: 2139-0002 EXPIRATION DATE: 01/31/2006
RESPS:4,000 HOURS:1,800 COSTS(000):$56
Quarterly Report of Class I Motor Carriers of Property (OMB
2139-0002)
FORMS: FORM-QFR
OMB NO: 2139-0004 EXPIRATION DATE: 01/31/2006
RESPS:3,000 HOURS:27,000 COSTS(000):$886
Annual Report of Class I and Class II Motor Carriers of Property
(OMB 2139-0004)
FORMS: FORM-M
OMB NO: 2139-0007 EXPIRATION DATE: 04/30/2004
RESPS:22,000 HOURS:8,700 COSTS(000):$0
Bureau of Transportation Statistics' Customer Satisfaction
Surveys Program
FORMS: NONE
OMB NO: 2900-0004 EXPIRATION DATE: 12/31/2005
RESPS:63,300 HOURS:79,125 COSTS(000):$0
Application for Dependency and Indemnity Compensation, Death
Pension and Accrued Benefits by a Surviving Spouse or Child
(Including Death Compensation if Applicable)
FORMS: 21-534
OMB NO: 2900-0005 EXPIRATION DATE: 04/30/2003
RESPS:20,880 HOURS:25,056 COSTS(000):$0
Application for Dependency and Indemnity Compensation by
parents(s) (Including Accrued Benfits and Death Compensation
When Applicable)
FORMS: 21-535
OMB NO: 2900-0006 EXPIRATION DATE: 09/30/2005
RESPS:2,400 HOURS:1,200 COSTS(000):$0
Application for Accrued Amouts of Veterans Benefits Payable to
Surviving Spouse, Child or Dependent Parents
FORMS: 21-614
OMB NO: 2900-0012 EXPIRATION DATE: 07/31/2004
RESPS:29,636 HOURS:4,939 COSTS(000):$0
Application for Cash Surrender or Policy Loan
FORMS: 29-1546 29-1546-1
OMB NO: 2900-0013 EXPIRATION DATE: 06/30/2003
RESPS:650,000 HOURS:162,500 COSTS(000):$0
Application for United States Flag for Burial Purposes
FORMS: 21-2008
OMB NO: 2900-0014 EXPIRATION DATE: 08/31/2005
RESPS:35,000 HOURS:2,917 COSTS(000):$0
Authorization and Certification of Entrance or Reentrance into
Rehabilitation and Certification of Status
FORMS: VA-28-1905
OMB NO: 2900-0017 EXPIRATION DATE: 10/31/2003
RESPS:24,868 HOURS:22,946 COSTS(000):$0
Court Appointed Fiduciarys Account (letter size), Federal
Fiduciary's Account, Account Book, and Court Appointed
Fiduciary's Account (legal size)
FORMS: 21-4706 21-4706B 21-4706C 21-4718
OMB NO: 2900-0018 EXPIRATION DATE: 04/30/2003
RESPS:11,100 HOURS:2,775 COSTS(000):$0
(1) Application for Accreditation as Service Organization
Representative, (2) Appointment of Individual as Claimant's
Representative
FORMS: VA-FORM-21 VA-FORM-22A
OMB NO: 2900-0020 EXPIRATION DATE: 09/30/2004
RESPS:83,500 HOURS:13,917 COSTS(000):$0
Designation of Beneficiary, Government Life Insurance
FORMS: VA-29-336
OMB NO: 2900-0021 EXPIRATION DATE: 05/31/2004
RESPS:279,000 HOURS:66,166 COSTS(000):$0
Notice of Default; Notice of Default and Intention to Foreclose;
Notice of Intention to Foreclose
FORMS: 26-6850 26-6850A 26-6851
OMB NO: 2900-0027 EXPIRATION DATE: 06/30/2005
RESPS:100 HOURS:33 COSTS(000):$0
Application for Accrued Benefits by Veteran's Surviving Spouse,
Child, or Dependent Parent
FORMS: 21-551
OMB NO: 2900-0028 EXPIRATION DATE: 10/31/2005
RESPS:196,200 HOURS:22,700 COSTS(000):$0
a. Application of Service Reresentative for Placement on Mailing
List b. Request for and Consen to Release of Information from
Claimant's Records c. Requests to Corespondent for Identifing....
FORMS: VA-3215 VA-3288 VA-70-2
OMB NO: 2900-0029 EXPIRATION DATE: 07/31/2005
RESPS:172,500 HOURS:57,917 COSTS(000):$0
VA Forms 26-6705, Offer to Purchase and Contract of Sale, VA
Form 26-6705b, Credit Statement of Prospective Purchaser, VA
Form 26-6705d, Addendum to VA Form 26-6705 (Virginia)
FORMS: 26-6705 26-6705B 26-6705D
OMB NO: 2900-0042 EXPIRATION DATE: 10/31/2003
RESPS:32,895 HOURS:32,895 COSTS(000):$0
Statement of Accredited Representative in Appealed Case
FORMS: 646
OMB NO: 2900-0043 EXPIRATION DATE: 03/31/2005
RESPS:226,000 HOURS:56,500 COSTS(000):$0
Declaration of Status of Dependents
FORMS: 21-686C
OMB NO: 2900-0045 EXPIRATION DATE: 12/31/2004
RESPS:300,000 HOURS:60,000 COSTS(000):$0
VA Request for Determination of Reasonable Value
FORMS: 26-1805
OMB NO: 2900-0046 EXPIRATION DATE: 09/30/2004
RESPS:312 HOURS:78 COSTS(000):$0
Statement of Heirs for Payment of Credits Due Estate of Veteran
FORMS: FL29-596
OMB NO: 2900-0049 EXPIRATION DATE: 08/31/2005
RESPS:177,500 HOURS:37,792 COSTS(000):$0
Request for Approval of School Attendance - VA Form 21-674 and
VA Form 21-674c. School Attendance Report- VA Form 21-674b.
FORMS: 21-674 21-674B 21-674C
OMB NO: 2900-0051 EXPIRATION DATE: 10/31/2003
RESPS:228 HOURS:228 COSTS(000):$0
Quarterly Report of State Approving Agency Activities
FORMS: 22-7398
OMB NO: 2900-0052 EXPIRATION DATE: 06/30/2005
RESPS:180,000 HOURS:45,000 COSTS(000):$0
Report of Medical Examination for Disability Evaluation
FORMS: 21-2545
OMB NO: 2900-0059 EXPIRATION DATE: 03/31/2005
RESPS:2,000 HOURS:4,000 COSTS(000):$0
Statement of Person Claiming to Have Stood in Relation of Parent
FORMS: VA-21-524
OMB NO: 2900-0064 EXPIRATION DATE: 07/31/2005
RESPS:750 HOURS:375 COSTS(000):$0
Application for Amounts Due Estates of Persons Entitled to
Benefits
FORMS: VA-FORM-21-609
OMB NO: 2900-0065 EXPIRATION DATE: 09/30/2004
RESPS:60,000 HOURS:15,000 COSTS(000):$0
Request for Employment Information in Connection with Claim for
Disability Benefits
FORMS: VA-21-4192
OMB NO: 2900-0066 EXPIRATION DATE: 09/30/2004
RESPS:5,167 HOURS:862 COSTS(000):$0
Request for Employment Information
FORMS: 29-459
OMB NO: 2900-0067 EXPIRATION DATE: 12/31/2005
RESPS:1,500 HOURS:375 COSTS(000):$0
Application for Automobile or Other Conveyance and Adaptive
Equipment (Under 38 U.S.C. 3901-3904)
FORMS: 21-4502
OMB NO: 2900-0074 EXPIRATION DATE: 12/31/2003
RESPS:120,300 HOURS:24,060 COSTS(000):$0
Request for Change of Program or Place of Training (Under
Chapters 30 and 32, Title 38, U.S. Code; Section 903 of Public
Law 96-342; or Chapter 1606, Title 10, U.S. Code)
FORMS: 22-1995
OMB NO: 2900-0075 EXPIRATION DATE: 06/30/2005
RESPS:752,000 HOURS:188,000 COSTS(000):$0
Statement in Support of Claim
FORMS: 21-4138
OMB NO: 2900-0080 EXPIRATION DATE: 10/31/2004
RESPS:480,100 HOURS:32,742 COSTS(000):$0
Claim for Payment of Cost of Unauthorized Medical Services;
Funeral Arrangements; Authority & Invoice for Travel by
Ambulance or other Hired Vehicle; Authorization & Invoice for
Medical....
FORMS: 10-583 10-2065 10-2511 10-7078
OMB NO: 2900-0085 EXPIRATION DATE: 07/31/2005
RESPS:39,782 HOURS:35,608 COSTS(000):$0
Appeal to Board of Veterans' Appeals, Withdrawal of Services by
a Representative, Filing of Representatives' Fee Agreements and
Motions for Review of Such Agreements, Motion for Review of......
FORMS: 9
OMB NO: 2900-0086 EXPIRATION DATE: 08/31/2005
RESPS:442,500 HOURS:110,625 COSTS(000):$0
Request for a Certificate of Eligibility for VA Home Loan
Benefits
FORMS: 26-1880
OMB NO: 2900-0089 EXPIRATION DATE: 03/31/2005
RESPS:40,000 HOURS:20,000 COSTS(000):$0
Statement of Dependency of Parent(s)
FORMS: 21-509
OMB NO: 2900-0090 EXPIRATION DATE: 11/30/2003
RESPS:30,000 HOURS:7,500 COSTS(000):$0
Application for Voluntary Service
FORMS: 10-7055
OMB NO: 2900-0091 EXPIRATION DATE: 03/31/2005
RESPS:5,985,000 HOURS:2,655,417 COSTS(000):$0
Application for Health Benefits
FORMS: VA-10-10EZ
OMB NO: 2900-0092 EXPIRATION DATE: 05/31/2004
RESPS:60,000 HOURS:30,000 COSTS(000):$0
Counseling Record - Personal Information
FORMS: 28-1902
OMB NO: 2900-0094 EXPIRATION DATE: 06/30/2005
RESPS:1,000 HOURS:250 COSTS(000):$0
Supplement to VA Forms 21-526, 21-534, and 21-535 (For
Philippine Claims)
FORMS: VA-21-4169
OMB NO: 2900-0095 EXPIRATION DATE: 03/31/2005
RESPS:25,000 HOURS:12,500 COSTS(000):$0
Pension Claim Questionnair for Farm Income
FORMS: VA-21-4165
OMB NO: 2900-0098 EXPIRATION DATE: 07/31/2003
RESPS:20,100 HOURS:10,050 COSTS(000):$0
Application for Survivors' and Dependents' Educational
Assistance (Under Chapter 35, Title 38 U.S.C.)
FORMS: 22-5490
OMB NO: 2900-0099 EXPIRATION DATE: 09/30/2004
RESPS:12,000 HOURS:3,000 COSTS(000):$0
Request for Change of Program or Place of Training Survivors'
and Dependents' Education Assistance (Under Provisions of
Chapter 35, Title 38 U.S.C.)
FORMS: VA-22-5495
OMB NO: 2900-0103 EXPIRATION DATE: 03/31/2005
RESPS:7,900 HOURS:1,975 COSTS(000):$0
Application for Dependency and Indemnity Compensation by Child
FORMS: VA-21-4183
OMB NO: 2900-0104 EXPIRATION DATE: 04/30/2003
RESPS:4,400 HOURS:2,200 COSTS(000):$0
Report of Accidental Injury in Support of Claim for Compensation
or Pension
FORMS: 21-4176
OMB NO: 2900-0105 EXPIRATION DATE: 03/31/2005
RESPS:13,200 HOURS:4,400 COSTS(000):$0
Statement of Witness to Accident
FORMS: 21-806
OMB NO: 2900-0107 EXPIRATION DATE: 12/31/2005
RESPS:4,316 HOURS:863 COSTS(000):$0
Certificate As To Assets
FORMS: 21-4709
OMB NO: 2900-0108 EXPIRATION DATE: 12/31/2005
RESPS:59,000 HOURS:29,500 COSTS(000):$0
Report of Income from Property or Business
FORMS: 21-4185
OMB NO: 2900-0110 EXPIRATION DATE: 07/31/2003
RESPS:4,082 HOURS:680 COSTS(000):$0
Application for Assumption Approval and/or Release From Personal
Liability to the Government on a Home Loan
FORMS: 26-6381
OMB NO: 2900-0111 EXPIRATION DATE: 10/31/2004
RESPS:9,000 HOURS:2,250 COSTS(000):$0
Statement of Purchaser or Owner Assuming Seller's Loan
FORMS: 26-6382
OMB NO: 2900-0112 EXPIRATION DATE: 08/31/2003
RESPS:7,000 HOURS:1,167 COSTS(000):$0
Statement of Holder or Servicer of Veteran's Loan
FORMS: 26-559
OMB NO: 2900-0116 EXPIRATION DATE: 05/31/2005
RESPS:1,664 HOURS:416 COSTS(000):$0
Notice of Department of Veterans Affairs of Veteran or
Beneficiary Incarcerated in Penal Institution
FORMS: 21-4193
OMB NO: 2900-0118 EXPIRATION DATE: 07/31/2004
RESPS:20,600 HOURS:3,433 COSTS(000):$0
Transfer of Scholastic Credit (Schools)
FORMS: 22-315
OMB NO: 2900-0119 EXPIRATION DATE: 10/31/2005
RESPS:20,277 HOURS:4,055 COSTS(000):$0
Report of Treatment in Hospital
FORMS: 29-551
OMB NO: 2900-0120 EXPIRATION DATE: 05/31/2005
RESPS:20,277 HOURS:5,069 COSTS(000):$0
Report of Treatment of Attending Physician
FORMS: FL-29-551A
OMB NO: 2900-0121 EXPIRATION DATE: 03/31/2006
RESPS:244 HOURS:61 COSTS(000):$0
Obtaining Supplemental Information from Hospital or Doctor
FORMS: 29-551B
OMB NO: 2900-0130 EXPIRATION DATE: 03/31/2005
RESPS:40,000 HOURS:20,000 COSTS(000):$0
Status of Loan Account - Foreclosure or Other Liquidation
FORMS: 26-567
OMB NO: 2900-0131 EXPIRATION DATE: 07/31/2005
RESPS:9,000 HOURS:3,000 COSTS(000):$0
Request for Supplemental Information on Medical and Nonmedical
Applications
FORMS: FL-29-615
OMB NO: 2900-0132 EXPIRATION DATE: 03/31/2006
RESPS:1,500 HOURS:250 COSTS(000):$0
Veteran's Application in Acquiring Specially Adapted Housing or
Special Home Adaptation Grant
FORMS: 26-4555
OMB NO: 2900-0133 EXPIRATION DATE: 09/30/2004
RESPS:700 HOURS:175 COSTS(000):$0
Application for Amounts on Deposit for Deceased Veteran
FORMS: VA-21-6898
OMB NO: 2900-0138 EXPIRATION DATE: 11/30/2004
RESPS:22,800 HOURS:5,700 COSTS(000):$0
Request for Details of Expenses
FORMS: 21-8049
OMB NO: 2900-0166 EXPIRATION DATE: 05/31/2005
RESPS:15,400 HOURS:1,284 COSTS(000):$0
Application for Ordinary Life Insurance and Information about
Modified Life
FORMS: 29-8485 29-8485A 29-8700A-E 29-8701A-E
OMB NO: 2900-0171 EXPIRATION DATE: 01/31/2006
RESPS:2,400 HOURS:1,200 COSTS(000):$0
Application and Enrollment Certification for Individualized
Tutorial Assistance
FORMS: 22-1990T
OMB NO: 2900-0176 EXPIRATION DATE: 03/31/2004
RESPS:12,000 HOURS:3,000 COSTS(000):$30
Monthly Record of Training and Wages
FORMS: 28-1905C
OMB NO: 2900-0178 EXPIRATION DATE: 03/31/2006
RESPS:120,600 HOURS:20,100 COSTS(000):$0
Monthly Certification of On-The-Job and Apprenticeship Training
FORMS: 22-6553D 22-6553D-1
OMB NO: 2900-0179 EXPIRATION DATE: 03/31/2005
RESPS:28 HOURS:14 COSTS(000):$0
Application for Change of Permanent Plan (Medical)
FORMS: 29-1549
OMB NO: 2900-0215 EXPIRATION DATE: 03/31/2005
RESPS:22,600 HOURS:3,767 COSTS(000):$0
Request for Information to make Direct Payment to Child Reaching
Majority
FORMS: 21-863
OMB NO: 2900-0216 EXPIRATION DATE: 06/30/2005
RESPS:3,750 HOURS:1,875 COSTS(000):$0
Application for Reimbursement from Accrued Amounts Due a
Deceased Beneficiary
FORMS: 21-601
OMB NO: 2900-0222 EXPIRATION DATE: 04/30/2004
RESPS:334,000 HOURS:83,500 COSTS(000):$0
Application for Standard Government Headstone or Marker for
Installation in Private or State Veterans' Cemetery
FORMS: 40-1330
OMB NO: 2900-0251 EXPIRATION DATE: 11/30/2005
RESPS:175,000 HOURS:29,167 COSTS(000):$0
Present Status of Loan
FORMS: 26-8778
OMB NO: 2900-0252 EXPIRATION DATE: 12/31/2004
RESPS:120 HOURS:50 COSTS(000):$0
Application for Authority to Close Loans on an Automatic Basis -
Nonsupervised Lenders
FORMS: 26-8736
OMB NO: 2900-0253 EXPIRATION DATE: 12/31/2004
RESPS:3,000 HOURS:1,000 COSTS(000):$0
Nonsuperivsed Lender's Nomination and Recommendation of Credit
Underwriter
FORMS: 26-8736A
OMB NO: 2900-0260 EXPIRATION DATE: 10/31/2004
RESPS:326,000 HOURS:10,867 COSTS(000):$0
Request for and Consent to Release of Medical Records Protected
by 38 U.S.C. 7332
FORMS: 10-5345
OMB NO: 2900-0261 EXPIRATION DATE: 03/31/2005
RESPS:50,000 HOURS:8,333 COSTS(000):$0
Application for Refund of Educational Contributions
FORMS: 24-5281
OMB NO: 2900-0262 EXPIRATION DATE: 10/31/2003
RESPS:2,500 HOURS:417 COSTS(000):$0
Designation of Certifying Official
FORMS: 22-8794
OMB NO: 2900-0325 EXPIRATION DATE: 07/31/2004
RESPS:21,353 HOURS:1,779 COSTS(000):$0
Certificate of Delivery of Advance Payment and Enrollment
FORMS: 22-1999V
OMB NO: 2900-0335 EXPIRATION DATE: 03/31/2004
RESPS:43,000 HOURS:14,333 COSTS(000):$0
Dental Record Authorization and Invoice for Outpatient Services
FORMS: 10-2570D
OMB NO: 2900-0342 EXPIRATION DATE: 08/31/2004
RESPS:600 HOURS:450 COSTS(000):$0
Application and On-the-Job Training Agreement and Standards and
Employer's Application to Provide Training
FORMS: 22-8864 22-8865
OMB NO: 2900-0355 EXPIRATION DATE: 03/31/2005
RESPS:56,000 HOURS:9,333 COSTS(000):$0
Verification of Pursuit of Course (Leading to a Standard College
Degree)
FORMS: VA-22-6553
OMB NO: 2900-0358 EXPIRATION DATE: 08/31/2003
RESPS:16,500 HOURS:8,250 COSTS(000):$0
Supplemental Information for Change of Program or Reenrollment
After Unsatisfactory Attendance, Conduct or Progress
FORMS: 22-8873
OMB NO: 2900-0377 EXPIRATION DATE: 02/29/2004
RESPS:842 HOURS:421 COSTS(000):$0
Claim for Repurchase of Loan
FORMS: VA/FORM26-8084
OMB NO: 2900-0379 EXPIRATION DATE: 11/30/2003
RESPS:164,000 HOURS:13,667 COSTS(000):$0
Time Record (Work-Study Program)
FORMS: 22-8690
OMB NO: 2900-0381 EXPIRATION DATE: 03/31/2006
RESPS:25,000 HOURS:4,167 COSTS(000):$0
Notice of Election to Convey and/or Invoice for Transfer of
Property
FORMS: 26-8903
OMB NO: 2900-0383 EXPIRATION DATE: 09/30/2004
RESPS:12 HOURS:6 COSTS(000):$0
Application for Educational Assistance Test Program Benefits
(Section 901, PL 96-342)
FORMS: 22-8889
OMB NO: 2900-0387 EXPIRATION DATE: 09/30/2004
RESPS:195,817 HOURS:16,318 COSTS(000):$0
Request for Verification of Deposit
FORMS: VA-26-8497A
OMB NO: 2900-0390 EXPIRATION DATE: 07/31/2005
RESPS:7,500 HOURS:2,500 COSTS(000):$0
Application of Surviving Spouse or Child for REPS Benefits
(Restored Entitlement Program for Survivors)
FORMS: 21-8924
OMB NO: 2900-0393 EXPIRATION DATE: 03/31/2005
RESPS:10,650 HOURS:10,650 COSTS(000):$0
Department of Veterans Affairs Acquisition Regulation (VAAR)
Part 813
FORMS: NONE
OMB NO: 2900-0394 EXPIRATION DATE: 04/30/2005
RESPS:1,200 HOURS:300 COSTS(000):$0
Certification of School Attendance - REPS
FORMS: 21-8926
OMB NO: 2900-0406 EXPIRATION DATE: 02/29/2004
RESPS:75,000 HOURS:6,250 COSTS(000):$0
Verification of a Benefit-Related Indebtedness
FORMS: 26-8937
OMB NO: 2900-0408 EXPIRATION DATE: 10/31/2005
RESPS:110 HOURS:36 COSTS(000):$0
Manufactured Home Loan Claim Under Loan Guaranty (Manufactured
Home Unit Only)--Manufactured Home Loan Claim Under Loan
Guaranty (Combination Loan - Manufactured Home Unit & Lot/Lot
Only)
FORMS: 26-8629 26-8630
OMB NO: 2900-0418 EXPIRATION DATE: 03/31/2005
RESPS:1,600 HOURS:1,030 COSTS(000):$0
VAAR Sections 809.106-1 and 809.504(d) and VAAR Clause 852.209-70
FORMS: NONE
OMB NO: 2900-0460 EXPIRATION DATE: 02/28/2006
RESPS:185,000 HOURS:30,833 COSTS(000):$0
Request for Verification of Employment
FORMS: 26-8497
OMB NO: 2900-0463 EXPIRATION DATE: 06/30/2005
RESPS:21,000 HOURS:3,500 COSTS(000):$0
Notice of Waiver of VA Compensation or Pension to Receive
Military Pay and Allowances
FORMS: 21-8951 21-8951-2
OMB NO: 2900-0466 EXPIRATION DATE: 10/31/2003
RESPS:23,700 HOURS:1,185 COSTS(000):$0
Certificate of Balance on Deposit and Authorization to Disclose
Financial Records
FORMS: 21-4178A
OMB NO: 2900-0469 EXPIRATION DATE: 05/31/2005
RESPS:2,078 HOURS:1,039 COSTS(000):$0
Certificate Showing Residence and Heirs of Dec. Vet. or Bene.
FORMS: 29-541
OMB NO: 2900-0519 EXPIRATION DATE: 09/30/2005
RESPS:2,025 HOURS:1,519 COSTS(000):$0
Locality Pay System for Nurses and Other Health Care Personnel
FORMS: 10-0132
OMB NO: 2900-0521 EXPIRATION DATE: 10/31/2004
RESPS:300,000 HOURS:1 COSTS(000):$0
Credit Underwriting Standards and Procedures for Processing VA
Guaranteed Loans
FORMS: NONE
OMB NO: 2900-0539 EXPIRATION DATE: 09/30/2004
RESPS:10,000 HOURS:3,333 COSTS(000):$0
Application for Supplemental Service Disabled Veterans Insurance
FORMS: 29-0188 29-0189 29-0190
OMB NO: 2900-0545 EXPIRATION DATE: 08/31/2005
RESPS:10,000 HOURS:7,500 COSTS(000):$0
Report of Medical, Legal, and Other Expenses Incident to
Recovery for Injury or Death
FORMS: 21-8416B
OMB NO: 2900-0548 EXPIRATION DATE: 12/31/2005
RESPS:6,000 HOURS:600 COSTS(000):$0
Generic Clearance for Board of Veterans' Appeals Customer
Satisfaction with Hearing Survey
FORMS: 0745
OMB NO: 2900-0554 EXPIRATION DATE: 04/30/2004
RESPS:1,100 HOURS:3,527 COSTS(000):$0
Homeless Providers Grant and Per Diem Program
FORMS: 10-0361
OMB NO: 2900-0556 EXPIRATION DATE: 09/30/2005
RESPS:243,000 HOURS:101,250 COSTS(000):$0
Advanced Directive - Living Will and Durable Power of Attorney
FORMS: 10-0137
OMB NO: 2900-0559 EXPIRATION DATE: 06/30/2004
RESPS:65 HOURS:65 COSTS(000):$0
State Cemetery Data
FORMS: 40-0241
OMB NO: 2900-0568 EXPIRATION DATE: 08/31/2005
RESPS:7,600 HOURS:1,900 COSTS(000):$0
Submission of School Catalog to the State Approving Agency
FORMS: NONE
OMB NO: 2900-0569 EXPIRATION DATE: 12/31/2003
RESPS:195,966 HOURS:26,810 COSTS(000):$0
VA Voluntary Customer Surveys to Implement E.O. 12862
FORMS: NONE
OMB NO: 2900-0577 EXPIRATION DATE: 03/31/2004
RESPS:2,000 HOURS:500 COSTS(000):$0
Spina Bifida Award Attachment Important Information
FORMS: 21-0307
OMB NO: 2900-0578 EXPIRATION DATE: 07/31/2004
RESPS:3,400 HOURS:3,400 COSTS(000):$0
Provision of Health Care to Vietnam Veterans' Children with
Spina Bifida-Regulation
FORMS: 10-7959E
OMB NO: 2900-0579 EXPIRATION DATE: 11/30/2005
RESPS:60 HOURS:15 COSTS(000):$0
Request for Vocational Training Benefits--Certain Children of
Vietnam Veterans (Title 38 CFR 21.8014)
FORMS: NONE
OMB NO: 2900-0594 EXPIRATION DATE: 08/31/2005
RESPS:36 HOURS:12 COSTS(000):$0
Election to Apply Selected Reserve Service to Either Montgomery
GI Bill - Active Duty or to the Montgomery GI Bill - Selected
Reserve -- 38 CFR 21.7042 and 21.7540
FORMS: NONE
OMB NO: 2900-0600 EXPIRATION DATE: 06/30/2004
RESPS:101,652 HOURS:50,826 COSTS(000):$0
Regulation for Reconsideration of Denied claims
FORMS: NONE
OMB NO: 2900-0605 EXPIRATION DATE: 04/30/2005
RESPS:20 HOURS:15 COSTS(000):$0
Application for Accreditation as a Claims Agent
FORMS: 21A
OMB NO: 2900-0606 EXPIRATION DATE: 05/31/2005
RESPS:400 HOURS:800 COSTS(000):$0
Regulation for Submission of Evidence - Title 38 CFR 17.1C1(a)(2)
FORMS: NONE
OMB NO: 2900-0609 EXPIRATION DATE: 02/28/2006
RESPS:57,500 HOURS:11,042 COSTS(000):$0
Survey of Veteran Enrollees' Health and Reliance Upon VA
FORMS: 10-21034G 10-21034H
OMB NO: 2900-0616 EXPIRATION DATE: 04/30/2004
RESPS:1,500 HOURS:250 COSTS(000):$0
Application for Furnishing Nursing Home Care to Beneficiaries of
Veterans Affairs
FORMS: 10-1170 10-2407
OMB NO: 2900-0637 EXPIRATION DATE: 11/30/2005
RESPS:7,933 HOURS:4,628 COSTS(000):$0
Longitudinal Health Study of Persian Gulf War Veterans
FORMS: 10-21055(NR)
OMB NO: 2900-0638 EXPIRATION DATE: 06/30/2003
RESPS:3,158 HOURS:525 COSTS(000):$0
Questionnaire for Coroners and Medical Examiners
FORMS: 21-0766
OMB NO: 2900-0641 EXPIRATION DATE: 02/29/2004
RESPS:3,500 HOURS:2,625 COSTS(000):$0
Study of Health and Communications of Veterans for the
War-Related Illness and Post-Deployment Health Issues Centers
(WRIISC)
FORMS: 10-21060(NR)
OMB NO: 2900-0642 EXPIRATION DATE: 09/30/2003
RESPS:24,000 HOURS:12,000 COSTS(000):$0
VA Copayment Refund - USAA/Hartford Claim Form
FORMS: 10-0406
OMB NO: 2900-0643 EXPIRATION DATE: 09/30/2004
RESPS:2,050 HOURS:683 COSTS(000):$0
Women Veterans Ambulatory Care Use: Patterns, Barriers, and
Influences
FORMS: 10-21063(NR)
OMB NO: 2020-0020 EXPIRATION DATE: 09/30/2004
RESPS:54 HOURS:4,300 COSTS(000):$0
Safe Drinking Water Act: Annual Public Water Systems Compliance
Report
FORMS: 1812.02
OMB NO: 2020-0022 EXPIRATION DATE: 08/31/2004
RESPS:700 HOURS:1,900 COSTS(000):$0
Compliance Assistance Surveys for the Marina, Metal Finishing,
Construction Site, and Auto Salvage Yard Sectors
FORMS: 2021.01
OMB NO: 2020-0023 EXPIRATION DATE: 10/31/2004
RESPS:289 HOURS:2,000 COSTS(000):$0
Proposed Information Collection Request for the Evaluation of
Print STEP.
FORMS: 1941.02
OMB NO: 2020-0027 EXPIRATION DATE: 05/31/2003
RESPS:1 HOURS:266 COSTS(000):$0
Survey of Air Quality Issues After September 11, 2001
FORMS: ICR-2094.01
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: 04/30/2003
RESPS:280 HOURS:76,752 COSTS(000):$0
Construction Grants Program Information Collection Request
FORMS: 0827.05
OMB NO: 2040-0042 EXPIRATION DATE: 01/31/2005
RESPS:422,287 HOURS:1,091,945 COSTS(000):$31,828
Underground Injection Control Program
FORMS: 0370.18 7520-1-TO-4 7520-6-TO-12 7520-14 7520-16
OMB NO: 2040-0049 EXPIRATION DATE: 08/31/2005
RESPS:298 HOURS:238,776 COSTS(000):$0
Water Quality Standards Regulation (40 CFR Part 131)
FORMS: 0988.08
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: 09/30/2005
RESPS:117 HOURS:65,057 COSTS(000):$0
Modification of Secondary Treatment Requirements for Discharges
into Marine Waters
FORMS: 0138.07
OMB NO: 2040-0090 EXPIRATION DATE: 11/30/2004
RESPS:494,815 HOURS:2,621,848 COSTS(000):$18,283
Public Water Systems Supervision Program: Public Notification
Amendment
FORMS: 0270.41
OMB NO: 2040-0095 EXPIRATION DATE: 04/30/2003
RESPS:111 HOURS:6,016 COSTS(000):$0
Construction Grants Delegation to States
FORMS: 0909.06
OMB NO: 2040-0101 EXPIRATION DATE: 02/29/2004
RESPS:200 HOURS:2,800 COSTS(000):$0
Questionnaire for Nominees for the Annual National Clean Water
Excellence Awards Program).
FORMS: 1287.06
OMB NO: 2040-0110 EXPIRATION DATE: 02/29/2004
RESPS:1,026,264 HOURS:1,375,412 COSTS(000):$0
Information Collection Request for the National Pollutant
Discharge Elimination System (NPDES) Compliance Assessment/
Certification Information
FORMS: ICR-1427.06
OMB NO: 2040-0118 EXPIRATION DATE: 11/30/2004
RESPS:2,244 HOURS:262,905 COSTS(000):$0
CWA State Revolving Fund Program
FORMS: 1391.06
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: 04/30/2003
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: 2040-0170 EXPIRATION DATE: 10/31/2004
RESPS:2.483 HOURS:580,044 COSTS(000):$182
Information Collection Request for the Combined Sewer Overflow
Policy
FORMS: 1680.03
OMB NO: 2040-0180 EXPIRATION DATE: 11/30/2004
RESPS:1,257 HOURS:122,863 COSTS(000):$0
National Pollutant Discharge Elimination System Great Lakes
Water Quality Guidance
FORMS: 1639.04
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: 10/31/2004
RESPS:15 HOURS:2,207 COSTS(000):$2
Establishing No-Discharge Zones (NDZs) Under Clean Water Act
Section 312
FORMS: 1791.03
OMB NO: 2040-0188 EXPIRATION DATE: 04/30/2003
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: 04/30/2003
RESPS:533 HOURS:1,280 COSTS(000):$1
National Health Protection Survey of Beaches
FORMS: 1814.02
OMB NO: 2040-0197 EXPIRATION DATE: 10/31/2004
RESPS:104 HOURS:2,608,787 COSTS(000):$7,102
State Source Water Assessment and Protection Programs
FORMS: 1816.02
OMB NO: 2040-0202 EXPIRATION DATE: 06/30/2005
RESPS:29 HOURS:1,418 COSTS(000):$0
Milestones Plan for the Bleached papergrade Kraft and Soda Sub-
category of the Pulp, Paper, and Paperboard Point Source Category
FORMS: 1877.02
OMB NO: 2040-0204 EXPIRATION DATE: 12/31/2004
RESPS:2,676,159 HOURS:4,337,535 COSTS(000):$148,459
Disinfectants/Disinfection Byproducts, Chemical, and Radionu-
clides Information Collection Request; Unregulated Contaminant
Monitoring Regulation List 2 Amendments (proposed rule)
FORMS: 1896.03
OMB NO: 2040-0207 EXPIRATION DATE: 06/30/2005
RESPS:130 HOURS:60,909 COSTS(000):$0
Best Management Practices (BMP) for Bleached Papergrade Kraft
and Soda Subcategory and the Papergrade Kraft Sulfite
Subcategory of the Pulp, Paper and Paperboard Point Source
Category
FORMS: 1829.02
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: 2040-0210 EXPIRATION DATE: 06/30/2003
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: 04/30/2003
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: 04/30/2003
RESPS:1,836 HOURS:128,736 COSTS(000):$14
Industry Detailed Questionnaire: Phase II Cooling Water Intake
Structures
FORMS: 1838.01
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: 2040-0226 EXPIRATION DATE: 01/31/2004
RESPS:92 HOURS:3,565 COSTS(000):$1
Information Collection Request for the National Listing of
Advisories
FORMS: 1959.01
OMB NO: 2040-0227 EXPIRATION DATE: 02/29/2004
RESPS:1,442 HOURS:3,381 COSTS(000):$0
Community Water System Survey
FORMS: 1946.01
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
OMB NO: 2040-0229 EXPIRATION DATE: 10/31/2004
RESPS:15,131 HOURS:330,329 COSTS(000):$6,653
Information Collection Request for Long Term 1 Enhanced Surface
Water Treatment Rule (Final Rule)
FORMS: 1928.03
OMB NO: 2040-0230 EXPIRATION DATE: 01/31/2004
RESPS:67 HOURS:47,168 COSTS(000):$0
Information Collection Request for Best Management Practices
Alternatives, Effluent Limitations Guidelines and Standards, Oil
and Gas Extraction Point Source Category (40 CFR Part 435)
FORMS: 1953.02
OMB NO: 2040-0231 EXPIRATION DATE: 01/31/2004
RESPS:49,813 HOURS:667,179 COSTS(000):$0
National Primary Drinking Water Regulations: Arsenic and
Clarifications to Compliance and New Source Contaminants
Monitoring
FORMS: EPA-ICR-1948.02
OMB NO: 2040-0237 EXPIRATION DATE: 08/31/2004
RESPS:6,000 HOURS:6,000 COSTS(000):$16
200 Aquatic Animal Production Industry Surveys
FORMS: 1988.01
OMB NO: 2040-0238 EXPIRATION DATE: 09/30/2004
RESPS:144 HOURS:336 COSTS(000):$0
National Wastewater Operator Training and Technical Assistance
Program - CWA 104(g)(1)
FORMS: 1977.01
OMB NO: 2040-0239 EXPIRATION DATE: 11/30/2004
RESPS:93 HOURS:9,261 COSTS(000):$0
Information Collection Request for Baseline Standards and Best
Management Practices for the Coal Mining Point Source Category
(40 CFR Part 434) - Coal Remining Subcategory and Western Alkalin
FORMS: 1944.02
OMB NO: 2040-0240 EXPIRATION DATE: 11/30/2004
RESPS:825 HOURS:19,840 COSTS(000):$12
2000 Aquatic Animal Production Industry Surveys
FORMS: 2038.01
OMB NO: 2040-0241 EXPIRATION DATE: 11/30/2004
RESPS:152 HOURS:40,376 COSTS(000):$1,766
Cooling Water Intake Structures New Facility Final Rule
FORMS: 1973.02
OMB NO: 2040-0242 EXPIRATION DATE: 02/28/2005
RESPS:86 HOURS:480 COSTS(000):$0
Certification in Lieu of Chloroform Minimum Monitoring Require-
ments for Direct and Indirect Discharging Mills in the Bleached
Papergrade Kraft and Soda Subcategory of the Public, Paper,...
FORMS: 2015.01
OMB NO: 2040-0243 EXPIRATION DATE: 02/28/2005
RESPS:104 HOURS:36,858 COSTS(000):$19,002
Minimum Monitoring Requirements for Direct and Indirect
Discharg- ing Mills in the Bleached Papergrade Kraft and Soda
Subcategory and the Papergrade Sulfite Subcategory of the Pulp,
Paper, ...
FORMS: 1878.01
OMB NO: 2040-0244 EXPIRATION DATE: 07/31/2005
RESPS:35 HOURS:69,755 COSTS(000):$473
US EPA BEACH Act Grant Program
FORMS: 2048.01
OMB NO: 2040-0246 EXPIRATION DATE: 10/31/2005
RESPS:60 HOURS:4,347 COSTS(000):$123
Laboratory Quality Assurance Evaluation Program for Analysis of
Cryptosporidium Under the Safe Drinking Water Act
FORMS: 2067.02
OMB NO: 2040-0248 EXPIRATION DATE: 07/31/2003
RESPS:535 HOURS:6,300 COSTS(000):$0
2003 Report to Congress on Impacvts and Control of Combined
Sewer Overflows and Sanitary Sewer Overflows
FORMS: 2063.01
OMB NO: 2040-0253 EXPIRATION DATE: 09/30/2003
RESPS:22,499 HOURS:2,652,392 COSTS(000):$82
Title VI of the Public Health Security and Bioterrorism Pre-
paredness and Response Act of 2002: Drinking Water Security and
Safety
FORMS: 2103.01
OMB NO: 2050-0039 EXPIRATION DATE: 05/31/2005
RESPS:2.20 HOURS:3,612,539 COSTS(000):$2,416
Requirements for Generators, Transporters, and Disposers under
the RCRA Hazardous Waste Manifest System
FORMS: 0801.14
OMB NO: 2050-0041 EXPIRATION DATE: 07/31/2005
RESPS:50 HOURS:19,968 COSTS(000):$0
Final Authorization for Hazardous Waste Management
FORMS: 0969.06
OMB NO: 2050-0046 EXPIRATION DATE: 04/30/2004
RESPS:23,726 HOURS:97,277 COSTS(000):$0
Notification of Episodic Releases of Oil and Hazardous Sub-
stances (Renewal)
FORMS: 1049.09
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: 2050-0072 EXPIRATION DATE: 10/31/2004
RESPS:504,000 HOURS:2,028,701 COSTS(000):$6,391
Community Right-to-Know Reporting Requirements under section 311
and 312 of the Emergency Planning and Community Right-to- Know
Act (EPCRA) - Minimal Hazard Proposed Rule
FORMS: 1352.09
OMB NO: 2050-0073 EXPIRATION DATE: 12/31/2005
RESPS:1,969 HOURS:307,949 COSTS(000):$26,353
Information Requirements for Boilers and Industrial Furnaces:
General Hazardous Waste Facility Standards, Specific Unit
Require ments, & Part B Permit Applicaition and Modification
Requirements
FORMS: 1361.09
OMB NO: 2050-0077 EXPIRATION DATE: 08/31/2004
RESPS:200 HOURS:1,800 COSTS(000):$0
Application for Reimbursement to Local Governments for Emergency
Response to Hazardous Substance Releases Under CERCLA section 123
FORMS: 1425.05 9310-1
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: 2050-0139 EXPIRATION DATE: 05/31/2004
RESPS:1,740 HOURS:64,260 COSTS(000):$0
Reporting and Recordkeeping Requirements Under EPA's WasteWise
Program
FORMS: 1698.04
OMB NO: 2050-0141 EXPIRATION DATE: 01/31/2004
RESPS:28 HOURS:826 COSTS(000):$150
The National Oil and Hazardous Substances Pollution Contingency
Plan Subpart J (Product Schedule)
FORMS: 1664.04
OMB NO: 2050-0143 EXPIRATION DATE: 04/30/2004
RESPS:1,562 HOURS:9,334 COSTS(000):$1
Exports from and Imports to the United States under
International and Bilateral Waste Agreements
FORMS: 1647.03
OMB NO: 2050-0144 EXPIRATION DATE: 10/31/2005
RESPS:5,550 HOURS:97,160 COSTS(000):$6
Information Collection Requirements for Registration and
Documentation of Risk Management Plans under Section 112r of the
Clean Air Act.
FORMS: 1656.09
OMB NO: 2050-0145 EXPIRATION DATE: 11/30/2004
RESPS:133,181 HOURS:218,168 COSTS(000):$3
Reporting and Recording Requirements for the Universal Waste
Handlers and Destination Facilities
FORMS: 1597.04
OMB NO: 2050-0152 EXPIRATION DATE: 06/30/2005
RESPS:6 HOURS:3,189 COSTS(000):$0
State Program Adequacy Determination: Municipal Solid Waste
Landfills (MSWLFs) and Non-municipal, Non-hazardous Waste
Disposal Units that Receive Conditionally Exempt Small
FORMS: 1608.03
OMB NO: 2050-0154 EXPIRATION DATE: 11/30/2005
RESPS:145 HOURS:9,675 COSTS(000):$938
Criteria for Clssification of Solid Waste Disposal Facilities
and Practices -- 40 CFR Part 257 Subpart B.
FORMS: 1745.04
OMB NO: 2050-0171 EXPIRATION DATE: 10/31/2004
RESPS:930 HOURS:71,075 COSTS(000):$1,612
Amendments to the Reporting and Recordkeeping Requirements for
National Emissions Standards for Hazardous Air Pollutants
(NESHAP) for Hazardous Waste Combustors - Direct Final Rule.
FORMS: 1773.05
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: 2050-0173 EXPIRATION DATE: 01/31/2004
RESPS:5 HOURS:93 COSTS(000):$1
Hazardous Waste Listing for Chlorinated Aliphatics Production
Wastes
FORMS: 1924.02
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
OMB NO: 2050-0179 EXPIRATION DATE: 11/30/2004
RESPS:581 HOURS:5,115 COSTS(000):$0
Cooperative Agreements and Superfund State Contracts for
Superfund Response Actions
FORMS: 1487.07
OMB NO: 2060-0016 EXPIRATION DATE: 09/30/2005
RESPS:44 HOURS:1,760 COSTS(000):$14
NSPS for Metallic Mineral Processing Plants (Subpart LL)
FORMS: 0982.07
OMB NO: 2060-0019 EXPIRATION DATE: 01/31/2004
RESPS:71 HOURS:1,796 COSTS(000):$3,568
New Source Performace Standards for Nitric Acid Plants, Subpart
G, Part 60
FORMS: 1056.07
OMB NO: 2060-0021 EXPIRATION DATE: 04/30/2003
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: 11/30/2005
RESPS:430 HOURS:17,359 COSTS(000):$91
Standards of Performance for Petroleum Refineries (40 CFR Part
60 Subpart J)
FORMS: 1054.08
OMB NO: 2060-0023 EXPIRATION DATE: 04/30/2003
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: 11/30/2004
RESPS:448 HOURS:7,968 COSTS(000):$987
New Source Performance Standard for Portland Cement Plants, 40
CFR Part 60, Subpart F
FORMS: 1051.08
OMB NO: 2060-0026 EXPIRATION DATE: 04/30/2003
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: 07/31/2004
RESPS:1,650 HOURS:93,439 COSTS(000):$0
NSPS-Standard of Performance for Stationary Gas Turbines 40 CFR
Part 60, Subpart GG
FORMS: 1071.07
OMB NO: 2060-0029 EXPIRATION DATE: 10/31/2005
RESPS:10 HOURS:1,012 COSTS(000):$26
NSPS for Iron and Steel Plants: Basic Oxygen Process Furnaces
(40 CFR Part 60, Subparts N and Na)
FORMS: 1069.07
OMB NO: 2060-0060 EXPIRATION DATE: 02/29/2004
RESPS:2 HOURS:1,722 COSTS(000):$0
Emission Control System Performance Warranty Regulations and
Voluntary Aftermath Part Certification Program, 40 CFR Part 85,
Subpart V
FORMS: 0116.06
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: 1128.06
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: 04/30/2003
RESPS:121 HOURS:250 COSTS(000):$0
Information Requirements for Grain Elevators -- NSPS Subpart DD
FORMS: 1130.06
OMB NO: 2060-0083 EXPIRATION DATE: 04/30/2003
RESPS:200 HOURS:6,890 COSTS(000):$0
Hot Mix Asphalt Facilities -- NSPS Subpart I
FORMS: 1127.06
OMB NO: 2060-0084 EXPIRATION DATE: 04/30/2003
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: 08/31/2003
RESPS:1,800 HOURS:600 COSTS(000):$0
Investigation into Possible Noncompliance of Motor Vehicles
FORMS: 0222.6
OMB NO: 2060-0088 EXPIRATION DATE: 10/31/2004
RESPS:54 HOURS:11,448 COSTS(000):$29
Annual Updates of Emission Data to the Aerometric Information
Retrieval System (AIRS)
FORMS: 0916.11
OMB NO: 2060-0092 EXPIRATION DATE: 09/30/2004
RESPS:166 HOURS:2,232 COSTS(000):$35
NESHAP for Beryllium (40 CFR part 61, subpart C)
FORMS: 0193.07
OMB NO: 2060-0095 EXPIRATION DATE: 08/31/2003
RESPS:21,200 HOURS:14,400 COSTS(000):$1,296
Importation Requirements for Importation of Nonconforming Vehi-
cles
FORMS: 0010.09
OMB NO: 2060-0096 EXPIRATION DATE: 01/31/2005
RESPS:356 HOURS:85,496 COSTS(000):$0
Source Compliance and State Action Reporting
FORMS: 0107.07
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: 03/31/2006
RESPS:123,008 HOURS:342,249 COSTS(000):$0
NESHAP for Asbestos, 40 CFR Part 61, Subpart M
FORMS: 0111.10
OMB NO: 2060-0104 EXPIRATION DATE: 07/31/2005
RESPS:70 HOURS:514,000 COSTS(000):$7,100
Motor Vehicle Emission and Fuel Economy Compliance; Light Duty
Vehicles, Light Duty Trucks and Motorcycle (Consolidated/Renewal)
FORMS: 0783.42
OMB NO: 2060-0105 EXPIRATION DATE: 10/31/2004
RESPS:60 HOURS:3,871 COSTS(000):$0
New Source Performance Standards for Graphic Arts Industry, 40
CFR Part 60, Subpart QQ
FORMS: 0657.07
OMB NO: 2060-0106 EXPIRATION DATE: 04/30/2003
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: 12/31/2005
RESPS:404 HOURS:14,531 COSTS(000):$318
NSPS for Metal Coil Surface Coating (Subpart TT)
FORMS: 0660.08
OMB NO: 2060-0108 EXPIRATION DATE: 04/30/2003
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: 02/29/2004
RESPS:82 HOURS:5,351 COSTS(000):$232
NSPS Smelters: Subpart M - Secondary Brass and Bronze Production
Subpart P - Primary Copper; Subpart Q - Primary Zinc, Subpart R
- Primary Lead; Subpart S - Primary Aluminum Reduction Plants;
...
FORMS: 1604.06
OMB NO: 2060-0111 EXPIRATION DATE: 10/31/2004
RESPS:31 HOURS:3,002 COSTS(000):$327
NSPS Subpart NN Phosphate Rock Plants
FORMS: ICR-1078.06
OMB NO: 2060-0150 EXPIRATION DATE: 01/31/2004
RESPS:9,200 HOURS:18,500 COSTS(000):$28
Registration of Fuels and Fuel Additives: Requirements for
Manufacturers (40 CFR 79)
FORMS: 309.10 3520-12 3250-13 3520-16 3520-13A
OMB NO: 2060-0156 EXPIRATION DATE: 10/31/2004
RESPS:79 HOURS:13,151 COSTS(000):$17
Standards of Performance for New Stationary Sources; Rubber Tire
Manufacturing, Subpart 40 CFR Part 60, Subpart BBB
FORMS: 1158.07
OMB NO: 2060-0161 EXPIRATION DATE: 02/29/2004
RESPS:3,093 HOURS:7,653 COSTS(000):$1,501
40 CFR 60.530 thru 60.539(b), New Source Performance Standards
for New Residential Wood Heaters (Subpart AAA)
FORMS: 1176.06
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: 05/31/2005
RESPS:1,842 HOURS:7,357 COSTS(000):$0
Recordkeeping and Periodic Reporting of the Production, Import,
Recycling, Destruction, Transshipment and Feedstock Use of
Ozone- Depleting Substances
FORMS: 1432.21
OMB NO: 2060-0171 EXPIRATION DATE: 02/29/2004
RESPS:56 HOURS:3,891 COSTS(000):$93
New Source Performance Standards (NSPS) for Magnetic Tape Coat-
ing Facilities, 40 CFR Part 60, Subpart SSS
FORMS: 1135.07
OMB NO: 2060-0172 EXPIRATION DATE: 09/30/2004
RESPS:320 HOURS:36,866 COSTS(000):$57
NSPS 40 CFR Part 60, Subpart QQQ - Standards of Performance for
VOC Emissions form Petroleum Refinery Wastewater Systems - Re-
porting and Recordkeeping
FORMS: 1136.06
OMB NO: 2060-0185 EXPIRATION DATE: 08/31/2004
RESPS:76 HOURS:7,083 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants,
Benzene Emission from Benzene Storage Vessels and Coke
by-product re- covery plants. 40 CFR Part 61, Subparts L & Y
FORMS: 1080.10
OMB NO: 2060-0191 EXPIRATION DATE: 08/31/2005
RESPS:62 HOURS:5,812 COSTS(000):$231
National Emission Standards for Hazardous Air Pollutants:
Radionuclides - (40 CFR Part 61) Subparts B, H, K, R, and W.
FORMS: 1100.00
OMB NO: 2060-0202 EXPIRATION DATE: 10/31/2004
RESPS:1,696 HOURS:432,767 COSTS(000):$13,185
NSPS 40 CFR Part 60, Subpart Dc - Standards of Performance for
Small Industrial-Commercial-Institutional Steam Generating Units
FORMS: 1564.05
OMB NO: 2060-0210 EXPIRATION DATE: 04/30/2005
RESPS:50 HOURS:11,885 COSTS(000):$132
NSPS Municipal Waste Combustors (MWC) for Subpart Ea and Subpart
Eb
FORMS: 1506.09
OMB NO: 2060-0220 EXPIRATION DATE: 12/31/2005
RESPS:299 HOURS:3,390 COSTS(000):$107
NSPS for Municipal Solid Waste Landfills, 40 CFR Part 60,
Subpart WWW
FORMS: ICR-1557.05
OMB NO: 2060-0226 EXPIRATION DATE: 10/31/2004
RESPS:330 HOURS:10,363 COSTS(000):$45
Information Collection Activities: Significant New Alternatives
Policy (SNAP) Program Final Rulemaking under Title VI of the
Clean Air Act Amendments of 1990, 40 CFR part 82, Subpart G.
FORMS: 1596.05
OMB NO: 2060-0251 EXPIRATION DATE: 12/31/2005
RESPS:342 HOURS:6,506 COSTS(000):$115
NSPS for Calciners and Dryers in Mineral Industries (40 CFR Part
60, Subpart UUU)
FORMS: 0746.05
OMB NO: 2060-0253 EXPIRATION DATE: 05/31/2005
RESPS:58 HOURS:104,659 COSTS(000):$0
National Emission Standards for Coke Oven Batteries, 40 CFR Part
63, Subpart L
FORMS: 1362.04
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: 04/30/2003
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: 06/30/2004
RESPS:4,555 HOURS:137,549 COSTS(000):$0
Application Requirements for the Approval and Delegation of
Federal Air Toxics Programs to State, Territorial, Local, and
Tribal Agencies
FORMS: 1643.04
OMB NO: 2060-0266 EXPIRATION DATE: 05/31/2005
RESPS:28,000 HOURS:172,200 COSTS(000):$0
Control Technology Determination for Equivalent Emission Limita-
tions by Permit
FORMS: 1648.04
OMB NO: 2060-0273 EXPIRATION DATE: 10/31/2003
RESPS:3,923 HOURS:45,207 COSTS(000):$4,091
NESHAP for Halogenated Solvent Cleaners/Halogenated Hazardous
Air Pollutants (40 CFR Part 63, subpart T)
FORMS: 1652.04
OMB NO: 2060-0275 EXPIRATION DATE: 10/31/2004
RESPS:69,558 HOURS:223,008 COSTS(000):$536
Detergent Gasoline: Certification Requirements for Manufac-
urers of Detergent Additives; Requirements for Transferors and
Transferees of Detergent Additives; Requirements for ...
FORMS: 1655.04
OMB NO: 2060-0277 EXPIRATION DATE: 04/30/2004
RESPS:53,171 HOURS:101,571 COSTS(000):$22,986
Regulation of Fuels and Fuel Additives: Reformulated Gasoline
Terminal Receipt Date
FORMS: 1591.14
OMB NO: 2060-0279 EXPIRATION DATE: 04/30/2005
RESPS:733 HOURS:10,246 COSTS(000):$0
General Conformity of Federal Actions to State Implemenation
Plan 40 CFR Part 51, Subpart W, Part 93, Subpart B
FORMS: 1637.05
OMB NO: 2060-0283 EXPIRATION DATE: 02/29/2004
RESPS:98 HOURS:7,328 COSTS(000):$228
NESHAP 40 CFR Part 63 Subpart O: National Emission Standards for
Hazardous Air Pollutants (NESHAP) for Commercial Ethylene Oxide
Sterilization and Fumigation Operations
FORMS: 1666.05
OMB NO: 2060-0287 EXPIRATION DATE: 09/30/2004
RESPS:779 HOURS:89,047 COSTS(000):$4,089
Non-road Compression-Ignition Engine and On-Highway Heavy Duty
Engine Application for Emissions Certification, and
Participation in the Averaging, Banking, and Trading Program 40
Part 86.094,...
FORMS: 1684.05
OMB NO: 2060-0289 EXPIRATION DATE: 05/31/2005
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: 1679.04
OMB NO: 2060-0290 EXPIRATION DATE: 09/30/2004
RESPS:29 HOURS:4,525 COSTS(000):$9
NESHAP: Epoxy Resin and Non-Nylon Polyamide Production - Subpart
W
FORMS: 1681.04
OMB NO: 2060-0294 EXPIRATION DATE: 08/31/2003
RESPS:150,215 HOURS:75,393 COSTS(000):$4,686
Reporting and Recordkeeping Requirements for Importation of
Nonconforming Nonroad Compression Ignition (CI) & Small Spark
Ignition (SI) Engines
FORMS: 1673.02 3520-1 3520-8 3520-14
OMB NO: 2060-0296 EXPIRATION DATE: 10/31/2003
RESPS:70 HOURS:16,033 COSTS(000):$150
NESHAP for the Secondary Lead Smelter Industry
FORMS: 1686.04
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: 11/30/2004
RESPS:188 HOURS:3,709 COSTS(000):$106
Retrofit/Rebuild Requirements for 1993 and Earlier Model Year
Urban Buses, 40 CFR Part 85
FORMS: 1702.03
OMB NO: 2060-0318 EXPIRATION DATE: 07/31/2004
RESPS:6,318 HOURS:672,640 COSTS(000):$1,460
Standards of Performance for Air Emission Standards for Tanks,
Surface Impoundments and Containers, 40 CFR Part 264, Subpart CC
and 40 CFR Part 265.
FORMS: 1593.05
OMB NO: 2060-0320 EXPIRATION DATE: 11/30/2004
RESPS:3,100 HOURS:1,550 COSTS(000):$78
Importation of Nonconforming Marine Engines: Reporting and
Record keeping Requirements
FORMS: 1723.03
OMB NO: 2060-0321 EXPIRATION DATE: 09/30/2004
RESPS:254 HOURS:38,674 COSTS(000):$2
Spark-ignition Marine Engine Application for Emission
Certification and Participation in the Averaging, Banking, and
Trading Program 40 CFR Part 91, Subpart B and C
FORMS: 1722.03
OMB NO: 2060-0322 EXPIRATION DATE: 10/31/2004
RESPS:68 HOURS:10,405 COSTS(000):$694
Marine Engine Manufacturer In-use Emission Testing Program Re-
porting and Recordkeeping, 40 CFR Part 91, Subpart N
FORMS: 1726.03
OMB NO: 2060-0323 EXPIRATION DATE: 09/30/2004
RESPS:340 HOURS:19,300 COSTS(000):$2,821
Marine Engine Manufacturer Production Line Testing Reporting and
Recordkeeping Requirements, 40 CFR Part 91
FORMS: 1725.03
OMB NO: 2060-0324 EXPIRATION DATE: 02/29/2004
RESPS:47,800 HOURS:92,071 COSTS(000):$41
National Emission Standards for Hazardous Air Pollutants
(NESHAP) from Wood Furniture Manufacturing Operations. 40 CFR
Part 63, Subpart JJ
FORMS: 1716.03
OMB NO: 2060-0325 EXPIRATION DATE: 02/29/2004
RESPS:526 HOURS:32,575 COSTS(000):$851
National Emission Standards for Hazardous Air Pollutants for
FORMS: 1659.04
OMB NO: 2060-0326 EXPIRATION DATE: 01/31/2004
RESPS:26 HOURS:7,042 COSTS(000):$89
NESHAP, Magnetic Tape Manufacturing Operations, 40 CFR Part 63,
Subpart EE
FORMS: 1678.04
OMB NO: 2060-0327 EXPIRATION DATE: 02/29/2004
RESPS:1,896 HOURS:516,186 COSTS(000):$75,300
NESHAP for Chromium Emissions from Hard and Decorative Chromium
Electroplating and Chromium Anodizing Tanks 40 CFR Part 63
(Subpart N)
FORMS: 1611.04
OMB NO: 2060-0328 EXPIRATION DATE: 11/30/2004
RESPS:120 HOURS:4,059 COSTS(000):$1
EPA's Natural Gas STAR Program
FORMS: 1763.03
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: 10/31/2004
RESPS:3,179 HOURS:15,323 COSTS(000):$0
Information Collection Request for Part 71 Federal Operating
Permit Regulations
FORMS: 1713.04
OMB NO: 2060-0337 EXPIRATION DATE: 10/31/2004
RESPS:53 HOURS:2,120 COSTS(000):$0
State Small Business Stationary Source Technical and Environ-
mental Compliance Assistance Program Annual Reporting Form
FORMS: 1748.03
OMB NO: 2060-0338 EXPIRATION DATE: 09/30/2004
RESPS:653 HOURS:47,736 COSTS(000):$3,240
Certification and the Averaging, Banking, and Trading Program
for Non-road Spark-Ingnition Engines at or Below 19 Kilowatts,
40 Part 90, Subpart C
FORMS: 1695.07
OMB NO: 2060-0340 EXPIRATION DATE: 12/31/2004
RESPS:314 HOURS:469,430 COSTS(000):$542
NESHAP for Petroleum Refineries, 40 CFR Part 63, Subpart CC
FORMS: 1692.04
OMB NO: 2060-0345 EXPIRATION DATE: 09/30/2004
RESPS:18 HOURS:4,338 COSTS(000):$0
Regulations for a Voluntary Emissions Standards Program
Applicable to Manufacturers of Light-Duty Vehicles and Trucks
Beginning in Model Year 1997 - 40 CFR 86.1700
FORMS: 1761.03
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: 2060-0358 EXPIRATION DATE: 02/29/2004
RESPS:209 HOURS:161,326 COSTS(000):$8
National Emission Standard for Hazardous Air Pollutants for
Source Categories; Pharmaceutical Production, 40 CFR Part 63,
Subpart GGG
FORMS: 1781.02
OMB NO: 2060-0363 EXPIRATION DATE: 11/30/2004
RESPS:2,349 HOURS:4,541 COSTS(000):$19
Standards of Performance for New Stationary Sources: Hospital/
Medical/Infectious Waste Incinerators, 40 CFR Part 60, Subpart Ec
FORMS: 1730.03
OMB NO: 2060-0369 EXPIRATION DATE: 09/30/2004
RESPS:205 HOURS:66,647 COSTS(000):$19
Transition Program for Equipment Manufacturers, 40 CFR Part 89.
101
FORMS: 1862.02
OMB NO: 2060-0370 EXPIRATION DATE: 10/31/2004
RESPS:375 HOURS:53,752 COSTS(000):$2,268
National Emissions Standards for Hazardous Air Pollutants-
Pesticide Active Ingredient Production, 40 CFR Part 63, Subpart
MMM
FORMS: ICR#1807.2
OMB NO: 2060-0373 EXPIRATION DATE: 10/31/2004
RESPS:600 HOURS:92,210 COSTS(000):$0
Control Technology Determinations for Constructed or Reconstruc-
ted Major Sources of Hazardous Air Pollutants, 40 CFR Part 63,
Subpart B
FORMS: 1658.03
OMB NO: 2060-0376 EXPIRATION DATE: 11/30/2004
RESPS:4,040 HOURS:172,698 COSTS(000):$9,699
Information Collection Request Update for the 40 CFR Part 64
Compliance Assurance Monitoring Program
FORMS: 1663.03
OMB NO: 2060-0377 EXPIRATION DATE: 12/31/2004
RESPS:125 HOURS:21,528 COSTS(000):$5
National Emission Standards for Hazardous Air Polluants for
Chemical Recovery Combustion Sources at Kraft, Soda, Sulfite,
and Stand-Alone Semichemical Pulp Mills
FORMS: 1805.03
OMB NO: 2060-0382 EXPIRATION DATE: 11/30/2004
RESPS:25 HOURS:14,950 COSTS(000):$139
PFC Emission Reduction Partnership for the Semiconductor
Industry, Non Rule Related, Memo of Understanding
FORMS: 1823.02
OMB NO: 2060-0387 EXPIRATION DATE: 11/30/2004
RESPS:500 HOURS:50,232 COSTS(000):$370
NESHAP for Total HAP Emissions form the Pulp Paper Production
Source Category - Process Operations, 40 CFR Part 63, Subpart S.
FORMS: 1657.04
OMB NO: 2060-0390 EXPIRATION DATE: 04/30/2003
RESPS:112 HOURS:58,915 COSTS(000):$3,218
Federal Plan Recordkeeping and Reporting Requirements for Large
Municipal Waste Combustors Constructed on or Before September
20, 1994 (Subpart FFF)
FORMS: 1847.02
OMB NO: 2060-0391 EXPIRATION DATE: 12/31/2004
RESPS:20 HOURS:746 COSTS(000):$0
NESHAP for Ferroalloys Production
FORMS: EPA-ICR-1831.02
OMB NO: 2060-0392 EXPIRATION DATE: 12/31/2004
RESPS:67 HOURS:11,121 COSTS(000):$388
Information Requirements for Locomotives and Locomotive Engines
FORMS: 1800.02
OMB NO: 2060-0393 EXPIRATION DATE: 04/30/2005
RESPS:745 HOURS:23,411 COSTS(000):$0
National Volatile Organic Compound Emission Standards for
Architechural Coatings
FORMS: 1750.03
OMB NO: 2060-0394 EXPIRATION DATE: 11/30/2004
RESPS:1 HOURS:8 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants for
Beryllium Rocket Motor Firing 40 CFR part 61, Subpart D.
FORMS: 1125.03
OMB NO: 2060-0395 EXPIRATION DATE: 08/31/2005
RESPS:12 HOURS:69 COSTS(000):$1
Exclucion Determinations for New Non-road Spark-ignited Engines
at or Below 19 Kilowats, New Non-road Compressionigintied
Engines New Marine Engines, and New on-raod Heavy Duty Engines
(40 CFR 85
FORMS: EPA-1852.02
OMB NO: 2060-0414 EXPIRATION DATE: 10/31/2005
RESPS:4 HOURS:12,246 COSTS(000):$40
National Emission Standard for Hazardous Air Pollutants (NESHAP)
for Primary Lead Smelters (40 CFR Part 63, Subpart TTT)
FORMS: 1856.03
OMB NO: 2060-0415 EXPIRATION DATE: 09/30/2005
RESPS:158 HOURS:88,680 COSTS(000):$513
NESHAP for Polyether Polyols Production (40 CFR part 63, Subpart
PPP)
FORMS: 1811.03
OMB NO: 2060-0416 EXPIRATION DATE: 10/31/2005
RESPS:214 HOURS:53,181 COSTS(000):$685
NESHAP for the Portland Cement Manufacturing Industry (40 CFR
Part 63, Subpart LLL)
FORMS: 1801.03
OMB NO: 2060-0417 EXPIRATION DATE: 08/31/2005
RESPS:996 HOURS:29,489 COSTS(000):$567
NESHAP: Oil and Natural Gas Production (40 CFR part 63, Subpart
HH)
FORMS: 1788.03
OMB NO: 2060-0418 EXPIRATION DATE: 09/30/2005
RESPS:14 HOURS:581 COSTS(000):$0
NESHAP: Natural Gas Transmission and Storage Facilities (40 CFR
Part 63, Subpart HHH)
FORMS: 1789.03
OMB NO: 2060-0419 EXPIRATION DATE: 10/31/2005
RESPS:231 HOURS:25,104 COSTS(000):$9
National Emission Standard for Hazardous Air Pollutants (NESHAP)
for Steel Pickling. (40 CFR, Subpart PPP)
FORMS: 1821.03
OMB NO: 2060-0420 EXPIRATION DATE: 12/31/2005
RESPS:30 HOURS:4,077 COSTS(000):$107
National Emission Standards for Hazardous Air Pollutants for
Source Categories: Generic Maximum Achievable Control Technology
(40 CFR Part 63, Subpart YY)
FORMS: 1871.03
OMB NO: 2060-0422 EXPIRATION DATE: 04/30/2003
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: 04/30/2003
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: 04/30/2003
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: 2060-0425 EXPIRATION DATE: 01/31/2004
RESPS:176 HOURS:1,256 COSTS(000):$1
Emission Defect Information and Voluntary Emission Recall
Reports for On-Highway, Light-Duty Vehicles
FORMS: 1916.01
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: 04/30/2003
RESPS:41 HOURS:41 COSTS(000):$0
NESHAP for Source Category: Publicly Owned Treatment Works
FORMS: 1891.02
OMB NO: 2060-0430 EXPIRATION DATE: 04/30/2003
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: 2060-0434 EXPIRATION DATE: 02/29/2004
RESPS:80 HOURS:32,252 COSTS(000):$80
National Emission Standard for Hazardous Air Pollutants: Manu-
facture of Amino/Phenolic Resins
FORMS: 1869.02
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: 2060-0437 EXPIRATION DATE: 01/31/2004
RESPS:192,268 HOURS:12,532 COSTS(000):$0
Recordkeeping and Reporting Requirements Regarding the Sulfur
Content of Motor Vehicle Gasoline Under the Tier 2 Rule.
FORMS: 1907.02
OMB NO: 2060-0439 EXPIRATION DATE: 11/30/2003
RESPS:5,000 HOURS:1,667 COSTS(000):$0
Information Collection Request: The Sun Wise School Program
FORMS: 1904.01
OMB NO: 2060-0442 EXPIRATION DATE: 01/31/2004
RESPS:4 HOURS:678 COSTS(000):$0
NSPS Subpart K, Storage Vessels for Petroleum Liquids for Which
Construction, Reconstruction, or Modification Commenced after
June 11.
FORMS: 1797.02
OMB NO: 2060-0443 EXPIRATION DATE: 08/31/2005
RESPS:10,361 HOURS:2,165,600 COSTS(000):$99,921
Synthetic Organic Chemical Industry (SOCMI): Consolidation of
Information Collection Request (Revision)
FORMS: 1854.03
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
OMB NO: 2060-0450 EXPIRATION DATE: 01/31/2004
RESPS:18 HOURS:11,209 COSTS(000):$14
Reporting and Recordkeeping Requirements for Standards of
Performance for New Stationary Sources: Commercial and Indus-
trial Solid Waste Incineration (CISWI) Units (Subpart CCC).
FORMS: 1926.02
OMB NO: 2060-0451 EXPIRATION DATE: 01/31/2004
RESPS:116 HOURS:9,145 COSTS(000):$0
Reporting and Recordkeeping Requirements for the Emission
Guidelines for Existing Commercial and Industrial Solid Waste
Incineration (CISWI) Units (Subpart DDDD).
FORMS: 1927.02
OMB NO: 2060-0460 EXPIRATION DATE: 10/31/2004
RESPS:30 HOURS:53,791 COSTS(000):$5,219
Information Requirements for Marine Diesel Engines (Nonroad
Large SI Engines and Marine Diesel Engines)(Amendments) (Final
Rule)
FORMS: 1897.04
OMB NO: 2060-0471 EXPIRATION DATE: 01/31/2005
RESPS:75 HOURS:10,092 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants:
Solvent Extraction for Vegetable Oil Production
FORMS: 1947.02
OMB NO: 2060-0478 EXPIRATION DATE: 06/30/2005
RESPS:12 HOURS:485 COSTS(000):$0
National Emission Standards for Hazardous Air Pollutants
(NESHAP) for Leather Finishing Operations
FORMS: 1985.02
OMB NO: 2060-0481 EXPIRATION DATE: 07/31/2005
RESPS:5 HOURS:1 COSTS(000):$2
Reporting and Recordkeeping Requirements for the Friction
Materials Manufacturing NESHAP
FORMS: 2025.01
OMB NO: 2060-0482 EXPIRATION DATE: 05/31/2005
RESPS:275 HOURS:97,605 COSTS(000):$99
Protection of Stratospheric Ozone: Request for Applications for
Critical use Exemptions from the Phaseout of Methyl Bromide
FORMS: 2031.01
OMB NO: 2060-0483 EXPIRATION DATE: 07/31/2005
RESPS:74 HOURS:1 COSTS(000):$2
National Emission Standards for Hazardous Air Pollutants for
Engine Test Cells/Stands.
FORMS: 2066.01
OMB NO: 2060-0486 EXPIRATION DATE: 08/31/2005
RESPS:180 HOURS:139,380 COSTS(000):$3
National Emission Standards for Hazardous Air Pollutants:
Miscellaneous Metal Parts and Products Surface Coating Operations
FORMS: 2056.01
OMB NO: 2060-0487 EXPIRATION DATE: 08/31/2005
RESPS:241 HOURS:25,048 COSTS(000):$236
Reporting and Recordkeeping Requirements for Metal Coil Surface
Coating Plants
FORMS: 1957.02
OMB NO: 2060-0488 EXPIRATION DATE: 08/31/2005
RESPS:9 HOURS:1,436 COSTS(000):$56
National Emission Standards for Hazardous Air Pollutants for
Cellulose Products Manufacturing (Final Rule)
FORMS: 1974.02
OMB NO: 2060-0489 EXPIRATION DATE: 08/31/2005
RESPS:275 HOURS:33,926 COSTS(000):$4,917
NESHAP for Source Categories: Generic Maximum Achievable Control
Technology Standards (Final Rule)
FORMS: 1983.02
OMB NO: 2060-0490 EXPIRATION DATE: 08/31/2005
RESPS:52,591 HOURS:726 COSTS(000):$0
National Survey on Environmental Management of Asthma
FORMS: 1996.01
OMB NO: 2060-0496 EXPIRATION DATE: 12/31/2005
RESPS:14 HOURS:2,983 COSTS(000):$2
Reporting & Recordkeeping Requirements of the National Emission
Standard for Hazardous Air Pollutants from Wet-formed Fiberglass
Mat Production Industry
FORMS: 1964.02
OMB NO: 2060-0502 EXPIRATION DATE: 02/28/2006
RESPS:1,000 HOURS:417 COSTS(000):$9,230
Eliciting Risk Tradeoffs for Valuing Fatal Cancer Risks
FORMS: 2057.01
Office of Prevention, Pesticides and Toxic Substances
OMB NO: 2070-0004 EXPIRATION DATE: 02/28/2006
RESPS:495 HOURS:2,344 COSTS(000):$0
Health and Safety Data Reporting; Submission of Lists and Copies
of Health and Safety Studies
FORMS: 0575.09
OMB NO: 2070-0012 EXPIRATION DATE: 07/31/2004
RESPS:1,674 HOURS:184,608 COSTS(000):$0
Pre-Manufacture Review Reporting and Exemption Requirements for
New Chemical Substances and Significant New Use Reporting
Requirements for Chemical Substances.
FORMS: 7710-25 7710-56 574.11
OMB NO: 2070-0017 EXPIRATION DATE: 12/31/2005
RESPS:7,397 HOURS:29,939 COSTS(000):$0
Recordkeeping and Reporting Requirements for Allegations of
Significant Adverse Reactions to Human Health or the Environment
(TSCA Section 8(c))
FORMS: 1031.07
OMB NO: 2070-0020 EXPIRATION DATE: 01/31/2006
RESPS:18,500 HOURS:5,550 COSTS(000):$0
Notice of Arrival of Pesticides and Devices (FIFRA)
FORMS: 0152.07 3540-1
OMB NO: 2070-0024 EXPIRATION DATE: 04/30/2003
RESPS:150 HOURS:258,900 COSTS(000):$0
Tolerance Petitions for Pesticides on Food/Feed Crops and New
Inert Ingredients
FORMS: 0597.07
OMB NO: 2070-0028 EXPIRATION DATE: 10/31/2004
RESPS:12,336 HOURS:24,672 COSTS(000):$0
Recordkeeping Requirements for Producers of Pesticides under
Section 8 of the Federal Insecticide, Pungicide, and Rodenticide
Act (FIFRA)
FORMS: 0143.07
OMB NO: 2070-0030 EXPIRATION DATE: 04/30/2003
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: 11/30/2004
RESPS:600 HOURS:59,400 COSTS(000):$0
Application and Summary Report for Emergency Exemption for
Pesticides
FORMS: 0596.07
OMB NO: 2070-0033 EXPIRATION DATE: 10/31/2004
RESPS:17,299 HOURS:1,182,574 COSTS(000):$0
TSCA Section 4 Test Rules, Consent Orders, Test Rule Exemptions,
and Voluntary Data Submission
FORMS: 1139.06
OMB NO: 2070-0038 EXPIRATION DATE: 01/31/2006
RESPS:8 HOURS:1,020 COSTS(000):$0
TSCA Section 5(a)(2) Significant New Use Rules for Existing
Chemicals
FORMS: 1188.07 7710-25
OMB NO: 2070-0039 EXPIRATION DATE: 01/31/2004
RESPS:260 HOURS:166,266 COSTS(000):$0
Submission of Unreasonable Adverse Effects Information Under
FIFRA Section 6(a)(2)
FORMS: 1204.08
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: 04/30/2003
RESPS:467 HOURS:8,209 COSTS(000):$0
Notification of Substantial Risk of Injury to Health and the
Environment under TSCA Secton 8(e)
FORMS: EPA-0794-09
OMB NO: 2070-0055 EXPIRATION DATE: 01/31/2006
RESPS:350 HOURS:18,200 COSTS(000):$0
Notice of Pesticide Registration by States to Meet a Special
Local Need (SLN) Under FIFRA Section 24(c)
FORMS: 0595.08 8570-25 8570-4
OMB NO: 2070-0057 EXPIRATION DATE: 08/31/2004
RESPS:68 HOURS:71,132 COSTS(000):$0
Data Call-Ins for the Special Review and Registration Review
Programs
FORMS: 0922.06 8570-32
OMB NO: 2070-0060 EXPIRATION DATE: 10/31/2005
RESPS:7,021 HOURS:152,974 COSTS(000):$0
Application for New and Amended Pesticide Registration
FORMS: 0277.13 8570-1 8570-4 8570-27 8570-34 8570-35 8570-36 8570-37
OMB NO: 2070-0091 EXPIRATION DATE: 10/31/2004
RESPS:107,551 HOURS:2,212,151 COSTS(000):$0
Asbestos-Containing Materials in Schools Rule and Asbestos Model
Accreditation Plan Rule (MAP)
FORMS: 1365.06
OMB NO: 2070-0093 EXPIRATION DATE: 10/31/2003
RESPS:88,117 HOURS:5,566,564 COSTS(000):$0
Toxic Chemical Release Reporting, Recordkeeping, Supplier
Notification and Petitions under Section 313 of the Emergency
Planning and Community Right-to-Know Act (EPCRA): Renewal
FORMS: ICR-1363-12 9350-1
OMB NO: 2070-0143 EXPIRATION DATE: 10/31/2003
RESPS:5,121 HOURS:463,670 COSTS(000):$0
Alternative Threshold for Low Annual Reportable Amounts; Toxic
Chemical Release Reporting Under Section 313 of the Emergency
Planning and Community Right-to-know Act (EPCRA): Renewal
FORMS: ICR-1704-06 9350-2
OMB NO: 2070-0145 EXPIRATION DATE: 01/31/2005
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 1741.03
OMB NO: 2070-0148 EXPIRATION DATE: 02/28/2005
RESPS:4,476,250 HOURS:2,294,625 COSTS(000):$0
Worker Protection Standard Training and Notification
FORMS: 1759.03
OMB NO: 2080-0048 EXPIRATION DATE: 02/29/2004
RESPS:1,511 HOURS:1,620 COSTS(000):$0
Request for Information for Bioremediation Field Initiative
Database System
FORMS: 1672.03
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: 2080-0058 EXPIRATION DATE: 10/31/2005
RESPS:30 HOURS:2,090 COSTS(000):$0
Personal Exposure of High-Risk Subpopulations to Particles
FORMS: 1887.02
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
OMB NO: 2080-0067 EXPIRATION DATE: 08/31/2005
RESPS:600 HOURS:525 COSTS(000):$0
Reliability, Validity, and Variability in Behavioral
Determinants of Drinking Water Disinfection By-Product Exposure
FORMS: 2030.01
OMB NO: 2080-0068 EXPIRATION DATE: 08/31/2005
RESPS:10,980 HOURS:5,000 COSTS(000):$0
Natioanal Epidemiological and Environmental Assessment of
Recreational Water Study (N.E.E.A.R.)
FORMS: 2081.01
