Information Collection

Potential Participant Contact Information

IC 239136 under ICR 202001-2127-001 · OMB 2127-0747.

Documents and Forms

Document Name Document Type
Form 1494 Potential Participant Contact Information Form and Instruction
1494 Contact Information Form 1494 Contact Information Form.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Potential Participant Contact Information	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

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	1494	Contact Information Form	1494 Contact Information Form.docx		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 300	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	300	300
Annual IC Time Burden (Hours)	5	5
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.