Information Collection

Passenger Facility Charge (PFC) Application- Extension

IC 228348 under ICR 201709-2120-015 · OMB 2120-0557.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0557 can be found here:

Documents and Forms

Document Name Document Type
Form 5500-1 Passenger Facility Charge (PFC) Application- Extension Form
14 CFR Part 158.doc www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9cd1b12b1ed95ca805342034af9edeb9&rgn=div5&view=text&node=14:3.0.1.3.28&idno=14 Instruction
5500-1 Passenger Facility Charge (PFC) Application pfc-5500-1-0817.pdf www.faa.gov/documentLibrary/media/Form/FAA%205500-1%20rev%2010-10.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Passenger Facility Charge (PFC) Application- Extension	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 14 CFR 158

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5500-1	Passenger Facility Charge (PFC) Application	pfc-5500-1-0817.pdf	http://www.faa.gov/documentLibrary/media/Form/FAA%205500-1%20rev%2010-10.pdf	Yes	Yes	Fillable Printable
Instruction			14 CFR Part 158.doc	http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9cd1b12b1ed95ca805342034af9edeb9&rgn=div5&view=text&node=14:3.0.1.3.28&idno=14	Yes	No	Printable Only

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 400	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1	1
Annual IC Time Burden (Hours)	10	10
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.