Information Collection

Create online disability service request form

IC 218423 under ICR 201510-2105-001 · OMB 2105-0571.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0571 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	Create online disability service request form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 14 CFR Part 382 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 135	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	135	135
Annual IC Time Burden (Hours)	4,320	4,320
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.