Information Collection

Enrollment Statement of Compliance and Checklist

IC 250876 under ICR 202601-2133-004 · OMB 2133-0553.

Documents and Forms

Document Name Document Type
Form MA-1085 EMBARC Statement of Compliance Enrollment Statement of Compliance and Checklist Form and Instruction
MA-1085 EMBARC Statement of Compliance MA-1085 EMBARC Statement of Compliance 9.29.2025.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Enrollment Statement of Compliance and Checklist	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MA-1085	EMBARC Statement of Compliance	MA-1085 EMBARC Statement of Compliance 9.29.2025.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 35	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	35	0	35
Annual IC Time Burden (Hours)	9	-61	70
Annual IC Cost Burden (Dollars)	0	-2,054	2,054

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.

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