Information Collection

Date of Separation reporting form (web #7)

IC 246047 under ICR 202406-2120-003 · OMB 2120-0607.

Documents and Forms

Document Name Document Type
Date of hire and seperation Record Collection Form.JPG Other-Web based form
Date of hire and seperation Record Collection Form.JPG Other-Web based form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Date of Separation reporting form (web #7)	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 135 14 CFR 121 14 CFR 111 14 CFR 125 14 CFR 91

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Web based form			Date of hire and seperation Record Collection Form.JPG		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title: DOT/ALL 13 Internet/Intranet Activity and Access Records	FR Citation: 67 FR 30758

Number of Respondents: 5,033	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	68,936	65,709	3,227
Annual IC Time Burden (Hours)	4,136	3,047	1,089
Annual IC Cost Burden (Dollars)	0	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.