Information Collection

SBTTAC Reporting (Center Burden)

IC 280383 under ICR 202605-2105-001 · OMB 2105-0554.

Documents and Forms

Document Name Document Type
Form DOT F 4500 SBTTAC Intake Form SBTTAC Reporting (Center Burden) Form
DOT F 4500 SBTTAC Intake Form DOT_F_4500_SBTRC_Field_Office_Intake_Form_Final_V1.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	SBTTAC Reporting (Center Burden)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 49 CFR Parts 23 and 26 (To search for a specific CFR, visit the Code of Federal Regulations.)

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DOT F 4500	SBTTAC Intake Form	DOT_F_4500_SBTRC_Field_Office_Intake_Form_Final_V1.pdf		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6	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
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	72	72
Annual IC Cost Burden (Dollars)	0	0

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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