Information Collection

Request and Response to Individualized Service Data

IC 263561 under ICR 202404-2140-001 · OMB 2140-0044.

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IC Title:

Request and Response to Individualized Service Data

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 49 CFR 1145.8(a)

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

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 16

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	16	16
Annual IC Time Burden (Hours)	1,152	1,152
Annual IC Cost Burden (Dollars)	0	0

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table that charts IC Documents
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.