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pdfPAPERWORK REDUCTION ACT
USITC IMPORT INJURY INVESTIGATIONS
GENERIC CLEARANCE SUBMISSION
OMB CONTROL NUMBER 3117-0016
This form should only be used if you are submitting a collection of information for approval under the USITC import injury
investigation clearance assigned OMB Control Number 3117-0016. Submit this form, responses to the supplemental questions (if
necessary), the collection instrument, and any additional documentation to: Office of Information and Regulatory Affairs, Office of
Management and Budget, Docket Library, Room 10102, 725 17th Street NW, Washington, D.C. 20503.
If the collection does not satisfy the requirements of the program clearance, you should follow the regular PRA clearance procedures
described in 5 CFR 1320.
Inv. no. & title
701–TA-459 and 731-TA-1155: Commodity Matchbooks from India (Final)
Agency contact (person who can best answer questions about the content of the submission)
Name
Amy Sherman
Phone
202-205-3289
E-mail
amy.sherman@usitc.gov
Burden hour estimates of the actual burden imposed (i.e., the
number of completed questionnaires EXPECTED to be returned
and the hours per response for a firm to (1) review instructions, (2)
search data sources, and (3) complete and review its questionnaire
response). Do NOT include anticipated certifications of nonapplicability here.
Number of
questionnaires
to be
mailed
Number of
responses
(1)
Hours
per
response
(2)
Cost
per
hour
(3)
Total
burden
hours
(1) x (2)
Cost per
response
(2) x (3)
Cumulative
burden
hours1
Type
USITC
number1
Producer questionnaire
09-1-2783
3
2
50
84.18
100
4,209
61,390
Importer questionnaire
09-2-2784
22
4
40
87.44
160
3,498
61,550
Purchaser questionnaire
09-3-2785
16
7
20
80.24
140
1,605
61,690
Foreign producer
questionnaire
09-4-2786
2
1
20
67.93
20
1,359
61,710
Notice of institution
09-5-
83.95
0
0
61,710
Other questionnaire
___________________
09-
0
0
61,710
420
3,221
61,710
Aggregate burden
1
14
30
Obtain from the Statistical Services Division.
Certification: The collections of information requested by this submission meet the requirement of the OMB approval for OMB
Control Number 3117-0016.
/s/ John Ascienzo
Signature of Program Official
Date
/s/ John Ascienzo
Signature of USITC Paperwork Clearance Officer
Date
Signature of OIRA Official
Date
Date submitted to OMB
Date approval received
Instructions for Submission under USITC Import Injury Investigation Clearance.
1.
Consult with the USITC Paperwork Clearance Officer to confirm that your survey meets the conditions for
submission under this clearance.
2.
If this collection or its subsequent analysis will employ statistical methods, complete Part B of the Supporting
Statement for the Form 83-I.
3.
Complete the cover sheet electronically and then print an sign it. As you enter data (or amend existing data) in
columns 1 (number of responses), 2 (hours per response), and 3 (cost per hour), the form will automatically
calculate the total burden hours, cost per response, and appropriate totals/averages. If you have no producer
questionnaires, no importer questionnaires, no purchaser questionnaires, or no foreign producer questionnaires,
please delete the hours per response value associated with the questionnaire(s) that you have no responses for. In
other words, if you have no foreign producer questionnaires, delete the “20" in the hours per response column.
The USITC Paperwork Clearance Officer will fill in the line marked “Cumulative Burden Hours under Program
Clearance.” Note: OMB will call the person listed as the Agency Contact to ask any questions about the survey.
4.
Give the cover sheet, the answers to Part B (if appropriate), a copy of the survey, and any other helpful
information to the USITC Paperwork Clearance Officer, who will review the materials, sign the cover sheet, and
send the package to OIRA. You will be notified when the survey is approved under OMB Control Number 31170016. Do not conduct the survey until you receive this approval.
File Type | application/pdf |
File Title | Q:\Investigators\Amy.Sherman\Commodity Matchbooks from India (F)\OMB Clearance Form.wpd |
Author | amy.sherman |
File Modified | 2009-07-22 |
File Created | 2009-07-15 |