Refusal to Take Alcohol Test Report to FAA

Anti-Drug Program for Personnel Engaged in Specified Aviation Activities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2120-0535 can be found here:

Documents and Forms

Document Name Document Type
14 CFR part 120.docx www.ecfr.gov/cgi-bin/text-idx?c=ecfr;sid=9d1f0081a4a84575efb21b5511b98172;rgn=div5;view=text;node=14%3A3.0.1.1.6;idno=14 Instruction

Information Collection (IC) Details

IC Title:	Refusal to Take Alcohol Test Report to FAA	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Mandatory

CFR Citation: 14 CFR 120

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			14 CFR part 120.docx	https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr;sid=9d1f0081a4a84575efb21b5511b98172;rgn=div5;view=text;node=14%3A3.0.1.1.6;idno=14;cc=ecfr	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 8	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 80 %

	Requested	Previously Approved
Annual Number of Responses for this IC	8	8
Annual IC Time Burden (Hours)	4	4
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.