ENDORSEMENT FOR MOTOR CARRIER POLICIES OF INSURANCE FOR AUTOMOBILE BODILY INJURY AND PROPERTY DAMAGE LIABILITY UNDER SECTION 10927 TITLE 49 OF THE UNITED STATES CODE
ICR 198212-3120-003
OMB: 3120-0086
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 3120-0086 can be found here:
ENDORSEMENT FOR MOTOR CARRIER
POLICIES OF INSURANCE FOR AUTOMOBILE BODILY INJURY AND PROPERTY
DAMAGE LIABILITY UNDER SECTION 10927 TITLE 49 OF THE UNITED STATES
CODE
Reinstatement with change of a previously approved collection
THIS RECORD ATTACHED TO EXISTING
INSURANCE POLICIES ENSURES THAT AN ICC REGULATED MOTOR CARRIER OF
PROPERTY OR PASSENGERS HAS THE MINIMUM REQUIRED AMOUNT OF PERSONAL
AND PROPERTY LIABILITY INSURANCE (49 CFR 1043). THE INSURANCE
COMPANIES USE THIS RECORD TO ESTABLISH THE CONTRACTURAL AGREEMENTS
THE ICC REQUIRES.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.