Information Collection

Withdrawal Questionnaire

IC 260529 under ICR 202605-0625-004 · OMB 0625-0280.

Documents and Forms

Document Name Document Type
0625-0280_instr_withdrawal qnr.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Withdrawal Questionnaire	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			0625-0280_instr_withdrawal qnr.pdf		Yes	Yes	Fillable Fileable

Line of Business: International Affairs and Commerce

Subfunction: Global Trade

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 75	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	75	-225	300
Annual IC Time Burden (Hours)	25	-75	100
Annual IC Cost Burden (Dollars)	1,930	-5,090	7,020

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.

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