Arbitrator's Report and Fee Statement

Arbitrator's Report and Fee Statement (FMCS Form R-19)

Documents and Forms

Document Name Document Type
Form R-19 Arbitrator's Report and Fee Statement Form
R-19 Arbitrator's Report and Fee Statement Form R-19 Final.pdf www.fmcs.gov/services/arbitration/information-fmcs-roster-arbitrators/ Form
R-19 Arbitrator's Report and Fee Statement Form R-19 Final.pdf www.fmcs.gov/services/arbitration/information-fmcs-roster-arbitrators/ Form

Information Collection (IC) Details

IC Title:	Arbitrator's Report and Fee Statement	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 29 CFR 1404

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	R-19	Arbitrator's Report and Fee Statement	Form R-19 Final.pdf	www.fmcs.gov/services/arbitration/information-fmcs-roster-arbitrators/	Yes	Yes	Fillable Fileable Signable

Line of Business: Litigation and Judicial Activities

Subfunction: Resolution Facilitation

Privacy Act System of Records
Title: Arbitration SORN	FR Citation: 87 FR 16737

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	2,000	0	2,000
Annual IC Time Burden (Hours)	333	-1	334
Annual IC Cost Burden (Dollars)	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.