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Federal forms, ICRs, and supporting documents

Information Collection Request

Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form

ICR 202603-3041-001 · OMB 3041-0142 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form CPSC 120 Compliance Verification Form Form Modified Repair queued
Form CPSC 120 Compliance Verification Form Form Modified Available
PoolSpaDrainSafetyCover_Supporting_Statement_2026_cleared.docx Supporting Statement A Uploaded 2026-03-30 Repair queued
PoolSpaDrainSafetyCover_Supporting_Statement_2026_cleared.docx Supporting Statement A Uploaded 2026-03-30 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
191497 Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form Form ModifiedCompliance Verification Form
191497 Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form Form ModifiedCompliance Verification Form
191497 Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form Form Modified
ICR Details
3041-0142 202603-3041-001
Active 202211-3041-003
CPSC
Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form
Extension without change of a currently approved collection   No
Regular
Approved without change 05/01/2026
Retrieve Notice of Action (NOA) 03/30/2026
  Inventory as of this Action Requested Previously Approved
05/31/2029 36 Months From Approved 04/30/2026
50 0 50
150 0 150
0 0 0
CPSC staff will fill in the form during the course of a pool and spa inspection to determine if the swimming pool and spa drain cover meets the requirements of ANSI/APSP 16 2017.
PL: Pub.L. 110 - 140 1404(b) Name of Law: Virginia Graeme Baker Pool and Spa Safety Act
  
None
Not associated with rulemaking
  90 FR 58231 12/16/2025
91 FR 12590 03/16/2026
No
1
IC Title Form No. Form Name
Virginia Graeme Baker Pool and Spa Safety Act Verification of Compliance Form CPSC 120 Compliance Verification Form
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 50 50 0 0 0 0
Annual Time Burden (Hours) 150 150 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$16,268
No
    Yes
    No
No
No
No
No
Cynthia Gillham 301 504-7701 [email protected]
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
03/30/2026