Certification and Agreement Forms for the Gas and Hazardous Liquid Safety Program

ICR 199901-2137-002

OMB: 2137-0584

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
2137-0584 199901-2137-002
Historical Active 199604-2137-001
DOT/PHMSA
Certification and Agreement Forms for the Gas and Hazardous Liquid Safety Program
Extension without change of a currently approved collection   No
Regular
Approved without change 02/05/1999
Retrieve Notice of Action (NOA) 01/05/1999
  Inventory as of this Action Requested Previously Approved
04/30/2002 04/30/2002 05/31/1999
1 0 61
3,678 0 3,649
0 0 0

States must submit information annually to provide documentation for grants to be used for pipeline safety programs.

None
None


No

1
IC Title Form No. Form Name
Certification and Agreement Forms for the Gas and Hazardous Liquid Safety Program

  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 1 61 0 0 -60 0
Annual Time Burden (Hours) 3,678 3,649 0 0 29 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.
01/05/1999


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