Information Collection

Safety Management System Checklist SMS Authority Approval

IC 250879 under ICR 202601-2133-004 · OMB 2133-0553.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form MA-1084 EMBARC Checklist Safety Management System Checklist SMS Authority Approval	Form and Instruction
MA-1084 EMBARC Checklist MA-1084 EMBARC Checklist.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 46 CFR 50101 (a)(4) 46 CFR 51322

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	MA-1084				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 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	35	0	35
Annual IC Time Burden (Hours)	70	0	70
Annual IC Cost Burden (Dollars)	0	-2,199	2,199

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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