THIS FORM IS REQUIRED TO BE FILED BY
ICC REGULATED MOTOR CARRIERS & TRANSPORTATION BROKERS
DESIGNATING AN AGENT TO ACCEPT SERVICE OF LEGAL PROCESS ON BEHALF
OF CARRIER FROM ANY COURT IN ANY ACTION BROUGHT AGANIST THE CARRIER
IN THE STATE NAMED. AN AGENT MUST BE NAMED FOR EACH STATE IN OR
THROUGH WHICH A CARRIER OPERATES.
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.