Request to Change End User, End Use and/or Destination of Hardware

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1405-0173 can be found here:

Documents and Forms

Document Name Document Type
Form DS-6004 Request to Change End User, End Use and/or Destination of Hardware Form
DS-6004 Request to Change End User, End Use and/or Destination o DS-6004 05 12 2005 v 019.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request to Change End User, End Use and/or Destination of Hardware	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 22 CFR 123

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DS-6004	Request to Change End User, End Use and/or Destination of Hardware	DS-6004 05 12 2005 v 019.pdf		Yes	No	Fillable Printable

Line of Business: International Affairs and Commerce

Subfunction: Foreign Affairs

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	650	0	650
Annual IC Time Burden (Hours)	1,470	820	650
Annual IC Cost Burden (Dollars)	15,000	0	15,000

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.