Application for Authority to Self-Insure Under 49 U.S.C. 13906

Financial Responsibility, Trucking and Freight Forwarding

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2126-0017 can be found here:

Documents and Forms

Document Name Document Type
Form BMC-40 Application for Authority to Self-Insure Under 49 U.S.C. 13906 Form and Instruction
BMC-40 Application for Authority to Self-Insure Under 49 U.S.C. BMC-40.021009.DOC Form and Instruction

Information Collection (IC) Details

IC Title:	Application for Authority to Self-Insure Under 49 U.S.C. 13906	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 387

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BMC-40	Application for Authority to Self-Insure Under 49 U.S.C. 13906	BMC-40.021009.DOC		Yes	No	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.