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23 CFR Parts Uniform Safety Program Cost Summary Form for Highway Safety Plan
23 CFR Parts Uniform Safety Program Cost Summary Form for Highway Safety Plan
OMB: 2127-0003
IC ID: 26124
OMB.report
DOT/NHTSA
OMB 2127-0003
ICR 201604-2127-002
IC 26124
( )
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:
Unchanged
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
Federal Enterprise Architecture Business Reference Module
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
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,140
0
0
0
0
1,140
Annual IC Time Burden (Hours)
570
0
0
0
0
570
Annual IC Cost Burden (Dollars)
0
0
0
0
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.