Information Collection

Passenger Facility Charge (PFC) Application

IC 25628 under ICR 201001-2120-004 · OMB 2120-0557.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0557 can be found here:

Documents and Forms

Document Name Document Type
Form 5500-1 Passenger Facility Charge (PFC) Application Form
5500-1 Passenger Facility Charge (PFC) Application 5500-1.pdf forms.faa.gov/redirect.asp?fnumber=5500-1&url=forms/faa5500-1.pdf&hit=1 Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Passenger Facility Charge (PFC) Application	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 14 CFR 158

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5500-1	Passenger Facility Charge (PFC) Application	5500-1.pdf	http://forms.faa.gov/redirect.asp?fnumber=5500-1&url=forms/faa5500-1.pdf&hit=1	Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 450	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	24,025	24,025
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.