23 CFR Parts Uniform Safety Program Cost Summary Form for Highway Safety Plan

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0003 can be found here:

Documents and Forms

Document Name Document Type
Form HS-FORM-217 23 CFR Parts Uniform Safety Program Cost Summary Form for Highway Safety Plan Form and Instruction
HS-FORM-217 Highway Safety Program Cost Summary HS 217 Form.DOC Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	23 CFR Parts Uniform Safety Program Cost Summary Form for Highway Safety Plan	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

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	HS-FORM-217	Highway Safety Program Cost Summary	HS 217 Form.DOC		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 57	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,140	1,140
Annual IC Time Burden (Hours)	570	570
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.