WRITTEN NOTICE OF DEATH AFTER FILLING ACCIDENT REPORT FORM MCS-50T OR 50B

ICR 198106-2125-001

OMB: 2125-0076

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
ICR Details
2125-0076 198106-2125-001
Historical Active
DOT/FHWA
WRITTEN NOTICE OF DEATH AFTER FILLING ACCIDENT REPORT FORM MCS-50T OR 50B
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 08/25/1981
Retrieve Notice of Action (NOA) 06/02/1981
  Inventory as of this Action Requested Previously Approved
06/30/1983 06/30/1983
30 0 0
2 0 0
0 0 0

AFTER AN ACCIDENT REPORT FORM MCS-50T OR 50B HAS BEEN FILED, IF A DEAT OCCURS WITHIN 30 DAYS FROM DATE OF ACCIDENT, WRITTEN NOTICE IS REQUIRE BY 49 CFR 394.11 DETAILING ITEMS TO BE USED TO DETERMINE IF AN INVESTIGATION IS WARRANTED AND TO UPDATE THE ACCIDENT DATA FILE.

None
None


No

1
IC Title Form No. Form Name
WRITTEN NOTICE OF DEATH AFTER FILLING ACCIDENT REPORT FORM MCS-50T OR 50B

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 30 0 0 0 30 0
Annual Time Burden (Hours) 2 0 0 0 2 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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.
06/02/1981


© 2024 OMB.report | Privacy Policy