Information Collection

Disability

IC 210315 under ICR 201411-1652-003 · OMB 1652-0030.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1652-0030 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Complaint Form (Version to OMB) (3).docx TBD-New on-line form	Other-On-line Form

IC Title:

Disability

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

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
Other-On-line Form			Complaint Form (Version to OMB) (3).docx	TBD-New on-line form	Yes	Yes	Fillable Printable

Line of Business: Homeland Security

Subfunction: Border and Transportation Security

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 12

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12	12
Annual IC Time Burden (Hours)	6	6
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.