Information Collection

23 CFR Parts Uniform Safety Program Cost Summary Form for Highway Safety Plan

IC 26124 under ICR 201604-2127-002 · OMB 2127-0003.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form HS-FORM-217 23 CFR Parts Uniform Safety Program Cost Summary Form for Highway Safety Plan	Form and Instruction
HS-FORM-217 Highway Safety Program Cost Summary HS_217_Form[2][1].doc	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

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
Form and Instruction	HS-FORM-217	Highway Safety Program Cost Summary	HS_217_Form[2][1].doc		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 57

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	1,140	1,140
Annual IC Time Burden (Hours)	570	570
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.