Information Collection

IC-10: Application for Authority to Self-Insure Under 49 U.S.C. 13906

IC 188066 under ICR 202410-2126-001 · OMB 2126-0017.

Documents and Forms

Document Name Document Type
Form BMC-40 IC-10: Application for Authority to Self-Insure Under 49 U.S.C. 13906 Form and Instruction
BMC-40 Application for Authority to Self-Insure Under 49 U.S.C. BMC-40 6-10-24 508.pdf www.fmcsa.dot.gov/registration/form-bmc-40-application-authority-self-insure-under-49-usc-13906 Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	IC-10: Application for Authority to Self-Insure Under 49 U.S.C. 13906	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 387

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	BMC-40	Application for Authority to Self-Insure Under 49 U.S.C. 13906	BMC-40 6-10-24 508.pdf	https://www.fmcsa.dot.gov/registration/form-bmc-40-application-authority-self-insure-under-49-usc-13906	Yes	No	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	2	2
Annual IC Time Burden (Hours)	80	80
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.