Information Collection

Application for Non-Premium Insurance

IC 25597 under ICR 202501-2120-001 · OMB 2120-0514.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 2120-0514 Application for FAA Non-Premium War Risk Hull and Liability Insurance Application for Non-Premium Insurance	Form and Instruction
2120-0514 Application for FAA Non-Premium War Risk Hull and Liabil Screen shot 2022.pdf aidms.faa.gov/ApplicationMoa	Form and Instruction

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:

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	2120-0514			https://aidms.faa.gov/ApplicationMoa	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4

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
	Requested	Previously Approved
Annual Number of Responses for this IC	4	4
Annual IC Time Burden (Hours)	16	16
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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