Information Collection

ATC Authorization Request

IC 222432 under ICR 201709-2120-017 · OMB 2120-0768.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0768 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Airspace Authorization - form and instructions 2-10-17.pdf	Other-Web Portal
Waiver request application.pdf	Other-Web Portal
Waiver application instructions.pdf	Instruction
DZ PA Statementv2.pdf DZ - PA Statement	IC Document
DZ Airspace Auth Screens.pdf DZ - Airspace Authorizations	IC Document
DZ Airspace Waiver Screens.pdf DZ - Airspace waivers	IC Document
DZ Ops Waiver Screens.pdf DZ - Operations Waivers	IC Document
DZ - justification.docx DZ - Justification	IC Document

IC Title:

ATC Authorization Request

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 14 CFR 107.41

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web Portal	Airspace Authorization - form and instructions 2-10-17.pdf	TBD	Yes	Yes	Fillable Fileable
Other-Web Portal	Waiver request application.pdf	TBD	Yes	Yes	Fillable Fileable
Instruction	Waiver application instructions.pdf	TBD	Yes	No	Fillable Printable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records

Title: DOT/FAA 801

FR Citation: 81 FR 54187

Number of Respondents: 19,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	19,000	19,000
Annual IC Time Burden (Hours)	9,500	9,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
DZ - PA Statement	DZ PA Statementv2.pdf	09/21/2017
DZ - Airspace Authorizations	DZ Airspace Auth Screens.pdf	09/21/2017
DZ - Airspace waivers	DZ Airspace Waiver Screens.pdf	09/21/2017
DZ - Operations Waivers	DZ Ops Waiver Screens.pdf	09/21/2017
DZ - Justification	DZ - justification.docx	09/21/2017

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