Information Collection

Request for Arbitration Services

IC 217949 under ICR 201508-3076-002 · OMB 3076-0002.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FMCS Form R-43 Request for Arbitration Services	Form
FMCS Form R-43 Request for Arbitration Panel SKMBT_C36015082016020.pdf	Form

IC Title:

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	FMCS Form R-43	Request for Arbitration Panel	SKMBT_C36015082016020.pdf		Yes	Yes	Printable Only

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: 13,179

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
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	13,179	13,179
Annual IC Time Burden (Hours)	2,196	2,196
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.