Information Collection

Overtime and Holiday Inspection Fees for Small and Very Small Establishments

IC 247113 under ICR 202109-0583-002 · OMB 0583-0185.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0583-0185 can be found here:

Documents and Forms

Document Name Document Type
Form 5200-16 Overtime and Holiday Inspection Fees for Small and Very Small Establishments Form and Instruction
5200-16 Overtime Holiday Rate Reduction Form FSIS 5200-16 9212021.docx Form and Instruction
5200-16 Overtime Holiday Rate Reduction Form FSIS 5200-16 9212021.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Overtime and Holiday Inspection Fees for Small and Very Small Establishments	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	5200-16	Overtime Holiday Rate Reduction Form	FSIS 5200-16 9212021.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,944	Number of Respondents for Small Entity: 3,944

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	3,944	3,944
Annual IC Time Burden (Hours)	724	724
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.