MOTOR CARRIER AUTOMOBILE BODILY INJURY AND PROPERTY DAMAGE LIABILITY CERTIFICATE OF INSURANCE

ICR 198610-3120-001

OMB: 3120-0103

Federal Form Document

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Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
3120-0103 198610-3120-001
Historical Active 198311-3120-001
ICC
MOTOR CARRIER AUTOMOBILE BODILY INJURY AND PROPERTY DAMAGE LIABILITY CERTIFICATE OF INSURANCE
Extension without change of a currently approved collection   No
Regular
Approved without change 10/23/1986
Retrieve Notice of Action (NOA) 10/02/1986
  Inventory as of this Action Requested Previously Approved
08/31/1989 08/31/1989 12/31/1986
25,000 0 25,000
6,250 0 6,250
0 0 0

THIS FORM ALLOWS REGULATED TRANSPORTATION COMPANIES TO SUBMIT MULTIPLE FILINGS IN ORDER TO AGGREGATE THEIR INSURANCE COVERAGE FROM THE FIRST DOLLAR AMOUNT LIABILITY COVERAGE. (49 U.S.C. 10927 AND 49 CFR 1043 AND 1084.)

None
None


No

1
IC Title Form No. Form Name
MOTOR CARRIER AUTOMOBILE BODILY INJURY AND PROPERTY DAMAGE LIABILITY CERTIFICATE OF INSURANCE BMC-91X

  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 25,000 25,000 0 0 0 0
Annual Time Burden (Hours) 6,250 6,250 0 0 0 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.
10/02/1986


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