Aviation Insurance

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
2120-0514 2015_revised.doc	Supporting Statement A	Uploaded 2015-09-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
25597	Aviation Insurance	Instruction	Modified

ICR Details

OMB Control No: 2120-0514	ICR Reference No: 201504-2120-004
Status: Historical Active	Previous ICR Reference No: 201110-2120-003
Agency/Subagency: DOT/FAA	Agency Tracking No:
Title: Aviation Insurance
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/09/2015
	Date Received in OIRA: 05/29/2015
Terms of Clearance: The collection has been approved for a period of 18 months. Before resubmission, the agency shall report on their progress to make the non-premium application PDF-Fillable and accept e-signatures in accordance with GPEA. Further, the agency shall reassess the burden of the application and the premium based program.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	36 Months From Approved	09/30/2015
Responses	154	0	61
Time Burden (Hours)	616	0	616
Cost Burden (Dollars)	0	0	0

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Abstract: The requested information is included in air carriers applications for insurance when insurance is not available from private sources.

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Authorizing Statute(s): PL: Pub.L. 107 - 296 1 Name of Law: Homeland Security Act of 2002
   US Code: 49 USC 443 Name of Law: Insurance
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 72055	12/04/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 19108	04/09/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Aviation Insurance	2120-0514	Application for FAA Non-Premium War Risk Hull and Liability Insurance

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	154	61	0	0	93	0
Annual Time Burden (Hours)	616	616	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $110,738

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/29/2015

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