Statement of Witness, Standard Form (SF) 94

ICR 202311-3090-001

OMB: 3090-0118

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2023-11-27
IC Document Collections
ICR Details
3090-0118 202311-3090-001
Received in OIRA 202008-3090-002
GSA
Statement of Witness, Standard Form (SF) 94
Extension without change of a currently approved collection   Yes
Regular 11/27/2023
  Requested Previously Approved
36 Months From Approved 12/31/2023
290 290
97 97
81,200 53,058

Standard Form (SF)94 is necessary to provide the Federal Government data on motor vehicle accidents and traffic violations. The form is used by persons who have witnessed an accident.

None
None

Not associated with rulemaking

  88 FR 64912 09/20/2023
88 FR 82893 11/27/2023
No

1
IC Title Form No. Form Name
Statement of Witness; Standard Form (SF) 94 SF 94 Statement of Witness

  Total Request 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 290 290 0 0 0 0
Annual Time Burden (Hours) 97 97 0 0 0 0
Annual Cost Burden (Dollars) 81,200 53,058 0 28,142 0 0
No
No

$2,437
No
    No
    Yes
No
No
No
No
Ray Wynter 202 501-3802

  Yes
 
Agency/Sub Agency RCF ID RCF Title RCF Status IC Title

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/27/2023


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