Information Collection

Passenger Facility Charge (PFC) Application

IC 25628 under ICR 202406-2120-002 · OMB 2120-0557.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 5500-1 Passenger Facility Charge (PFC) Application	Form
Form 5500-1 Passenger Facility Charge (PFC) Application Passenger Facility Charge (PFC) Application	Form
Form 5500-1 Attachment G Passenger Facility Charge (PFC) Application	Form
Form 5500-1 Attachment B Passenger Facility Charge (PFC) Application	Form
14 CFR Part 158.doc www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9cd1b12b1ed95ca805342034af9edeb9&rgn=div5&view=text&node=14:3.0.1.3.28&idno=14	Instruction
14 CFR Part 158.doc www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9cd1b12b1ed95ca805342034af9edeb9&rgn=div5&view=text&node=14:3.0.1.3.28&idno=14	Instruction
pfc_73_20_streamlined_procedures.pdf	Instruction
pfc_73_20_streamlined_procedures.pdf	Instruction
5500-1 Passenger Facility Charge (PFC) Application 5500-1 PFC Application 2024 draft.pdf	Form
5500-1 Passenger Facility Charge (PFC) Application 5500-1 PFC Application 2024 draft.pdf	Form
5500-1 Attachment G 5500-1 Attachment G 2024 draft.docx	Form
5500-1 Attachment G 5500-1 Attachment G 2024 draft.docx	Form
5500-1 Attachment B 5500-1 Attachment B 2024 draft.docx	Form
5500-1 Attachment B 5500-1 Attachment B 2024 draft.docx	Form

IC Title:

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 158

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	5500-1		Yes	Yes	Fillable Fileable Signable
Instruction		http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9cd1b12b1ed95ca805342034af9edeb9&rgn=div5&view=text&node=14:3.0.1.3.28&idno=14	Yes	No	Printable Only
Form	5500-1		Yes	Yes	Fillable Fileable Signable
Form	5500-1		Yes	Yes	Fillable Fileable Signable
Instruction			Yes	Yes	Fillable Fileable Signable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

table that charts list of burden
	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	9	-3	12
Annual IC Time Burden (Hours)	459	-369	828
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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