Information Collection

Passenger Facility Charge (PFC) Application- Amendment

IC 228349 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form 5500-1 Passenger Facility Charge (PFC) Application- Amendment	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

IC Title:

Passenger Facility Charge (PFC) Application- Amendment

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:

table that charts list of 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 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	125	125
Annual IC Time Burden (Hours)	2,000	2,000
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.