Request for Arbitration Services

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3076-0002 can be found here:

Documents and Forms

Document Name Document Type
Form Form R-43 Request for Arbitration Services Form and Instruction
Form R-43 Request for Arbitration Services FormR-43Expires12-31-2010-fill.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Request for Arbitration Services	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 1401

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form R-43	Request for Arbitration Services	FormR-43Expires12-31-2010-fill.pdf		Yes	Yes	Fillable Fileable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title: Privacy Act	FR Citation: 40 FR 47418

Number of Respondents: 10,000	Number of Respondents for Small Entity: 10,000

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

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,000	10,000
Annual IC Time Burden (Hours)	0	0
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.