Statement of Disability for Interagency Access Pass In-person Applicants

The Interagency Access Pass and Senior Pass Application Processes

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0252 can be found here:

Documents and Forms

Document Name Document Type
Statement of Disability for Interagency Access Pass In-person Applicants Form and Instruction
Statement of Disability Statement of Disability Form -2014.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Statement of Disability for Interagency Access Pass In-person Applicants	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	None	Statement of Disability	Statement of Disability Form -2014.pdf		No		Printable Only

Line of Business: Natural Resources

Subfunction: Recreational Resource Management and Tourism

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 76,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	76,000	6,270	69,730
Annual IC Time Burden (Hours)	6,333	522	5,811
Annual IC Cost Burden (Dollars)	0	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.