Information Collection

Records to be kept by employer

IC 185276 under ICR 201504-1625-002 · OMB 1625-0044.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1625-0044 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
1625-0044_Inst_r3_2014-cvc.doc	Instruction

IC Title:

Records to be kept by employer

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 33 CFR 141.35

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
Instruction					Yes	Yes	Printable Only

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,648

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	20,502	0	8,810	11,692
Annual IC Time Burden (Hours)	718	34	-96	780
Annual IC Cost Burden (Dollars)	0	0	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.

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