Information Collection

Application Stage

IC 257872 under ICR 202301-2125-001 · OMB 2125-0672.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2125-0672 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Wildlife_Crossings-Application Checklist 12.20.22.docx	Other-Applicaton Checklist

IC Title:

Application Stage

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 23 CFR 171

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-Applicaton Checklist			Wildlife_Crossings-Application Checklist 12.20.22.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	4,000	4,000
Annual IC Cost Burden (Dollars)	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.