Information Collection

Date of Hire reporting form (web #5)

IC 245993 under ICR 202212-2120-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Date of hire and seperation Record Collection Form.JPG	Other-web form
Date of hire and seperation Record Collection Form.JPG	Other-web form

IC Title:

Date of Hire reporting form (web #5)

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 121 14 CFR 111 14 CFR 135 14 CFR 125 14 CFR 91

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
Other-web form					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: 3,270

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	3,270	43	3,227
Annual IC Time Burden (Hours)	1,092	3	1,089
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

table that charts IC Documents
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.

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