Information Collection

Request for Relief and Release of Liability Statement

IC 185388 under ICR 200806-0596-003 · OMB 0596-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0596-0212 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FS-2400-71 Request for Relief and Release of Liability Statement	Form
FS-2400-71 Request for Relief and Release of Liability Statement FS_2400_71.doc	Form

IC Title:

Request for Relief and Release of Liability Statement

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FS-2400-71	Request for Relief and Release of Liability Statement	FS_2400_71.doc		No		Paper Only

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,030

Number of Respondents for Small Entity: 1,030

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	1,030	1,030
Annual IC Time Burden (Hours)	172	172
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.