Information Collection

Industry Safety Data

IC 258676 under ICR 202302-2138-002 · OMB 2138-0048.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Version 1.0 Industry Safety Data	Form and Instruction
Form Version 1.0 ISD Data Entry Form Industry Safety Data	Form and Instruction
Version 1.0 ISD Data Entry Form Copy of DataEntryTemplate.xlsm	Form and Instruction
Version 1.0 ISD Data Entry Form Copy of DataEntryTemplate.xlsm	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

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
Form and Instruction	Version 1.0				Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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)	400	400
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.

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