Information Collection

Application for Temporary Premium Insurance

IC 273747 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 Temporary Premium War Risk Hull and Liability Insurance Application for Temporary Premium Insurance	Form and Instruction
2120-0514 Application for FAA Temporary Premium War Risk Hull and TPP Application.pdf aidms.faa.gov/TemporaryPremiumInsuranceApp#step-1	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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/TemporaryPremiumInsuranceApp#step-1	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

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	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	30	30
Annual IC Time Burden (Hours)	120	120
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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