Information Collection

Arbitrator's Personal Data Questionnaire

IC 32213 under ICR 202202-3076-002 · OMB 3076-0001.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3076-0001 can be found here:

Documents and Forms

Document Name Document Type
Form R-22 Arbitrator's Personal Data Questionnaire Form and Instruction
R-22 Arbitrator's Personal Data Questionnaire 2-16-22 Form R-22.pdf www.fmcs.gov/services/arbitration/information-joining-arbitrator-roster/ Form and Instruction
R-22 Arbitrator's Personal Data Questionnaire 2-16-22 Form R-22.pdf www.fmcs.gov/services/arbitration/information-joining-arbitrator-roster/ Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Arbitrator's Personal Data Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 1404

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	R-22	Arbitrator's Personal Data Questionnaire	2-16-22 Form R-22.pdf	https://www.fmcs.gov/services/arbitration/information-joining-arbitrator-roster/	Yes	Yes	Fillable Fileable Signable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title: Arbitration SORN	FR Citation: 87 FR 16737

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	50	-50	100
Annual IC Time Burden (Hours)	125	25	100
Annual IC Cost Burden (Dollars)	0	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.