Form 10-597, "Access Pass – Statement of Disability" (In-person Applicants)

The Interagency Access Pass and Senior Pass Application Processes

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1024-0252 can be found here:

Documents and Forms

Document Name Document Type
Form 10-597 Form 10-597, "Access Pass – Statement of Disability" (In-person Applicants) Form and Instruction
10-597 Access Pass - Statement of Disability Form 10-597 Statement of Disability Form rev 02-2017 FINAL.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Form 10-597, "Access Pass – Statement of Disability" (In-person Applicants)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	10-597	Access Pass - Statement of Disability	Form 10-597 Statement of Disability Form rev 02-2017 FINAL.pdf		No		Printable Only

Line of Business: Natural Resources

Subfunction: Recreational Resource Management and Tourism

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 76,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	76,000	76,000
Annual IC Time Burden (Hours)	6,333	6,333
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.