Information Collection

IC-4.2 Hiring carrier provides prior employer safety history to applicant

IC 238308 under ICR 202012-2126-002 · OMB 2126-0004.

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Information Collection (IC) Details

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IC Title:	IC-4.2 Hiring carrier provides prior employer safety history to applicant	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR CFR 391.23(i)(2) (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

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 320,000	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 80 %

	Requested	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	320,000	2,000	318,000
Annual IC Time Burden (Hours)	16,000	100	15,900
Annual IC Cost Burden (Dollars)	0	0	0

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.