Information Collection

Redirection of Checkoff Assessments

IC 222421 under ICR 201607-0581-003 · OMB 0581-0294.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0581-0294 can be found here:

Documents and Forms

Document Name Document Type
Form QSBC-1 Redirection of Checkoff Assessments Form
QSBC-1 Producer Redirection of Checkoff assessments Form QSBC-1 - CBB Producer Redirection of Checkoff Assessments 7-12-16.doc Form
QSSB-1 Producer Redirection of Checkoff Assessments Form QSSB-1 - USB Producer Redirection of Checkoff Assessments 7-12-16.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Redirection of Checkoff Assessments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	QSBC-1	Producer Redirection of Checkoff assessments Form	QSBC-1 - CBB Producer Redirection of Checkoff Assessments 7-12-16.doc		No		Paper Only
Form	QSSB-1	Producer Redirection of Checkoff Assessments Form	QSSB-1 - USB Producer Redirection of Checkoff Assessments 7-12-16.doc		No		Paper Only

Line of Business: Economic Development

Subfunction: Business and Industry Development

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 30	Number of Respondents for Small Entity: 30

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	2	2
Annual IC Cost Burden (Dollars)	0	0

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.