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

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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[2][1].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[2][1].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 %

	Requested	Change Due to Potential Violation of the PRA
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
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.