Information Collection

Proof of Financial Responsibility - Optional Rider

IC 180149 under ICR 201010-3072-001 · OMB 3072-0018.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3072-0018 can be found here:

Documents and Forms

Document Name Document Type
Form FMC-48A Proof of Financial Responsibility - Optional Rider Form
FMC-48A Optional Rider for Additional NVOCC Financial Responsibi form48a.pdf www.fmc.gov/images/pages/form48a.pdf Form
FMC-69A Optional Rider for Additional NVOCC Financial Responsibi Form_69A_Optional_Rider_for_Additional_Financial_Responsibil.pdf www.fmc.gov/images/pages/Form_69A_Optional_Rider_for_Additional_Financial_Responsibil.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Proof of Financial Responsibility - Optional Rider	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 46 CFR 515.25

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	FMC-48A	Optional Rider for Additional NVOCC Financial Responsibility	form48a.pdf	http://www.fmc.gov/images/pages/form48a.pdf	Yes	No	Printable Only
Form	FMC-69A	Optional Rider for Additional NVOCC Financial Responsibility for Group Bonds	Form_69A_Optional_Rider_for_Additional_Financial_Responsibil.pdf	http://www.fmc.gov/images/pages/Form_69A_Optional_Rider_for_Additional_Financial_Responsibil.pdf	Yes	No	Printable Only

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 68	Number of Respondents for Small Entity: 68

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

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	68	57	11
Annual IC Time Burden (Hours)	23	19	4
Annual IC Cost Burden (Dollars)	0	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.