Information Collection

Request for Arbitration Services

IC 198539 under ICR 201107-3076-002 · OMB 3076-0002.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3076-0002 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form R-43 Request for Arbitration Services	Form and Instruction
Form R-43 Request for Arbitration Services FormR-43Expires12-31-2010-fill.pdf	Form and Instruction

IC Title:

Request for Arbitration Services

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 1401

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 and Instruction	Form R-43	Request for Arbitration Services	FormR-43Expires12-31-2010-fill.pdf		Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records

Title: Privacy Act

FR Citation: 40 FR 47418

Number of Respondents: 10,000

Number of Respondents for Small Entity: 10,000

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	0	0
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.