Water Efficiency Collection - State/Local Governments

EPA's WaterSense Program (Renewal)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2040-0272 can be found here:

Documents and Forms

Document Name Document Type
Form 6100-06 Water Efficiency Collection - State/Local Governments Form and Instruction
Attachment 21_Awards Statement_Promotional Partner.pdf Instruction
6100-06 Parthership Agreement - Promotional Attachment 6_Partnership Agreement_Promotional Partner.pdf www.epa.gov/watersense/docs/ws_partnership_promo_508_2-1-13.pdf Form and Instruction
6100-09 Annual Reporting Form - Promotional Attachment 11_Annual Reporting_Promotional.pdf Form and Instruction
6100-17 Awards Application Form - Promotional Attachment 28_Awards Form_Promotional Partner.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Water Efficiency Collection - State/Local Governments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	6100-06	Parthership Agreement - Promotional	Attachment 6_Partnership Agreement_Promotional Partner.pdf	http://www.epa.gov/watersense/docs/ws_partnership_promo_508_2-1-13.pdf	Yes	No	Fillable Printable
Form and Instruction	6100-09	Annual Reporting Form - Promotional	Attachment 11_Annual Reporting_Promotional.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	6100-17	Awards Application Form - Promotional	Attachment 28_Awards Form_Promotional Partner.pdf		Yes	Yes	Fillable Fileable
Instruction			Attachment 21_Awards Statement_Promotional Partner.pdf		Yes	No	Printable Only

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 353	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	353	27	326
Annual IC Time Burden (Hours)	1,284	51	1,233
Annual IC Cost Burden (Dollars)	363	-22	385

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.