Request for Waiver of Service Obligation, request for Deferment of Service Obligation, Application for Review

ICR 200502-2133-003

OMB: 2133-0510

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
2133-0510 200502-2133-003
Historical Active 200203-2133-001
DOT/MARAD
Request for Waiver of Service Obligation, request for Deferment of Service Obligation, Application for Review
Extension without change of a currently approved collection   No
Regular
Approved without change 07/06/2005
Retrieve Notice of Action (NOA) 02/15/2005
  Inventory as of this Action Requested Previously Approved
07/31/2008 07/31/2008 07/31/2005
25 0 61
9 0 21
0 0 0

Students and graduates of the U.S. Merchant Marine Academy and State maritime academies are required to complete these forms when requesting waivers and deferments of the service obligation.

None
None


No

1
IC Title Form No. Form Name
Request for Waiver of Service Obligation, request for Deferment of Service Obligation, Application for Review MA-935, MA-936, MA-937

  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 61 0 -36 0 0
Annual Time Burden (Hours) 9 21 0 -12 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes

$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.
02/15/2005


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