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OMB Control No: 2090-0029	ICR Reference No: 202403-2090-002
Status: Received in OIRA	Previous ICR Reference No: 202104-2090-001
Agency/Subagency: EPA/AdmO	Agency Tracking No: 2260.08
Title: Confidential Financial Disclosure Form for Special Government Employees at the US Environmental Protection Agency (Renewal)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 03/12/2024

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2024
Responses	325	325
Time Burden (Hours)	325	325
Cost Burden (Dollars)	0	0

Annual Cost to Federal Government: $88,725

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

Agency Contact: Gina Moore 202 566-0462 moore.gina@epa.gov