Information Collection

405b Assessment (State Respondents)

IC 230624 under ICR 202202-2127-002 · OMB 2127-0730.

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IC Title:

405b Assessment (State Respondents)

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 23 CFR 405

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

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	9	0	9
Annual IC Time Burden (Hours)	792	72	720
Annual IC Cost Burden (Dollars)	292,500	292,500	0

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

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