Information Collection

Request for Deferment of Service Obligation

IC 229402 under ICR 201712-2133-001 · OMB 2133-0510.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2133-0510 can be found here:

Documents and Forms

Document Name Document Type
Form MA-936 Request for Deferment of Service Obligation Form and Instruction
MA-936 Request for Deferment of Service Obligation MA-936 Request for Deferment of Service Obligation.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Deferment of Service Obligation	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MA-936	Request for Deferment of Service Obligation	MA-936 Request for Deferment of Service Obligation.pdf		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Water Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5	5
Annual IC Time Burden (Hours)	3	3
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.