Information Collection

Request for Arbitration Panel, FMCS Form R-43

IC 255768 under ICR 202604-3076-001 · OMB 3076-0016.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FMCS Form R-43 Request for Arbitration Panel Request for Arbitration Panel, FMCS Form R-43	Form
Form FMCS Form R-43 Request for Arbitration Panel Request for Arbitration Panel, FMCS Form R-43	Form
FMCS Form R-43 Request for Arbitration Panel R-43 Final.pdf	Form
FMCS Form R-43 Request for Arbitration Panel R-43 Final.pdf	Form

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: 29 CFR 1404

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	FMCS Form R-43				Yes	Yes	Fillable Fileable Signable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records

Title: Arbitration Records SORN

FR Citation: 87 FR 16737

Number of Respondents: 2,000

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	333	333
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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