Information Collection

Date of Separation reporting form (web #7)

IC 246047 under ICR 202012-2120-002 · OMB 2120-0607.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0607 can be found here:

Documents and Forms

Document Name Document Type
Date of hire and seperation Record Collection Form.JPG Other-Web based form
Date of hire and seperation Record Collection Form.JPG Other-Web based form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Date of Separation reporting form (web #7)	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 135 14 CFR 121 14 CFR 111 14 CFR 125 14 CFR 91

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web based form			Date of hire and seperation Record Collection Form.JPG		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title: DOT/ALL 13 Internet/Intranet Activity and Access Records	FR Citation: 67 FR 30758

Number of Respondents: 3,227	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	3,227	3,227
Annual IC Time Burden (Hours)	1,089	1,089
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.