Information Collection

Form 3520-21, Individuals

IC 184205 under ICR 201702-2060-007 · OMB 2060-0320.

Documents and Forms

Document Name Document Type
Form 3520-21 Form 3520-21, Individuals Form and Instruction
3520-21 Engine Declarations Form Form3520-21.pdf www.epa.gov/otaq/imports/forms/3520-21.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Form 3520-21, Individuals	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 85 40 CFR 91 40 CFR 94 40 CFR 90 40 CFR 92 40 CFR 89 40 CFR 1068

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	3520-21	Engine Declarations Form	Form3520-21.pdf	http://www.epa.gov/otaq/imports/forms/3520-21.pdf	Yes	No	Fillable Printable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,000	Number of Respondents for Small Entity: 4,000

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 5 %

	Approved	Previously Approved
Annual Number of Responses for this IC	4,000	4,000
Annual IC Time Burden (Hours)	2,000	2,000
Annual IC Cost Burden (Dollars)	8,000	8,000

Documents for IC

Title	Document	Date Uploaded
No associated records found

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