Information Collection

Request for Relief and Release of Liability Statement

IC 185388 under ICR 200806-0596-003 · OMB 0596-0212.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0596-0212 can be found here:

Documents and Forms

Document Name Document Type
Form FS-2400-71 Request for Relief and Release of Liability Statement Form
FS-2400-71 Request for Relief and Release of Liability Statement FS_2400_71.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Relief and Release of Liability Statement	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:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FS-2400-71	Request for Relief and Release of Liability Statement	FS_2400_71.doc		No		Paper Only

Line of Business: Natural Resources

Subfunction: Conservation, Marine and Land Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,030	Number of Respondents for Small Entity: 1,030

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	1,030	1,030
Annual IC Time Burden (Hours)	172	172
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.