Aviation Insurance

Forms and Documents

Document Name	Status
Form 2120-0514 Aviation Insurance Form and Instruction	Modified
Form 2120-0514 Update - Aircraft Schedule Form and Instruction	New
Form 2120-0514 Update - Business Information Form and Instruction	New
Form 2120-0514 Update - Commercial Pollicy Submission Form and Instruction	New
49 USC Chapter 443- Insurance.pdf Supplementary Document	2019-04-09
2120-0514 2018 JWP ((004) final after passback.docx Supporting Statement A	2019-04-09

IC Document Collections

IC ID	Document Title	Status
25597	Aviation Insurance Form and Instruction	Modified
233349	Update - Aircraft Schedule Form and Instruction	New
233348	Update - Business Information Form and Instruction	New
233347	Update - Commercial Pollicy Submission Form and Instruction	New

ICR Details

OMB Control No: 2120-0514	ICR Reference No: 201810-2120-001
Status: Active	Previous ICR Reference No: 201504-2120-004
Agency/Subagency: DOT/FAA	Agency Tracking No:
Title: Aviation Insurance
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/10/2019
	Date Received in OIRA: 10/29/2018
Terms of Clearance: Made adjustments to clarify the circumstances of the collection and to improve the assumptions and sourcing related to hourly wage rates.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2022	36 Months From Approved
Responses	114	0	0
Time Burden (Hours)	28	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Air carriers, operators that are members of the Civil Reserve Air Fleet (CRAF) or direct contractors to DOD supporting the President's initiatives are required to respond to this collection to receive the benefit of insurance. The FAA may use any information submitted by applicants for chapter 443 insurance to identify the eligibility of parties to be insured, the amount of coverage required, and insurance premiums. Without collection of this information, the FAA would not be able to issue required insurance.

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Authorizing Statute(s): US Code: 49 USC 443 Name of Law: Insurance
   PL: Pub.L. 107 - 296 1 Name of Law: Homeland Security Act of 2002
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 26537	06/07/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 46775	09/14/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Update - Commercial Pollicy Submission	2120-0514	Application for FAA Non-Premium War Risk Hull and Liability Insurance
Aviation Insurance	2120-0514	Application for FAA Non-Premium War Risk Hull and Liability Insurance
Update - Business Information	2120-0514	Application for FAA Non-Premium War Risk Hull and Liability Insurance
Update - Aircraft Schedule	2120-0514	Application for FAA Non-Premium War Risk Hull and Liability Insurance

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	114	0	0	26	-66	154
Annual Time Burden (Hours)	28	0	0	-15	-573	616
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: There has been a change to the hourly burden since the previous submission. Some reasons are the Premium Program currently does not exist which eliminates the burden associated with updates to the Premium Program. All participants only file an initial application one time (we do not expect more than 4 applications for Non-premium insurance.) The public cost burden has been adjusted for inflation since the last report in 2015. The agency has separated collection activity into appropriate information collections, there has not been additional forms or applications added.

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Annual Cost to Federal Government: $861

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 10/29/2018

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