Public Agency Quarterly PFC Report to Air Carriers

Passenger Facility Charge (PFC) Application

Documents and Forms

Document Name Document Type
14 CFR Part 158.doc www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9cd1b12b1ed95ca805342034af9edeb9&rgn=div5&view=text&node=14:3.0.1.3.28&idno=14 Instruction
5500-3 PFC Financial Completion Form 5500-3 Financial Completion Form draft.docx Form and Instruction
5500-4 PFC Physical Completion Form 5500-4 Physical Completion Form draft.docx Form and Instruction
PA Qtrly Report Revenue Form PA Quarterly Report Revenue draft.png Form
PA Qtrly Report Disbursements Form PA Quarterly Report Disbursements draft.png Form

Information Collection (IC) Details

IC Title:	Public Agency Quarterly PFC Report to Air Carriers	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation: 14 CFR 158

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			14 CFR Part 158.doc	http://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=9cd1b12b1ed95ca805342034af9edeb9&rgn=div5&view=text&node=14:3.0.1.3.28&idno=14	Yes	No	Printable Only
Form and Instruction	5500-3	PFC Financial Completion Form	5500-3 Financial Completion Form draft.docx		Yes	Yes	Fillable Fileable Signable
Form and Instruction	5500-4	PFC Physical Completion Form	5500-4 Physical Completion Form draft.docx		Yes	Yes	Fillable Fileable Signable
Form	N/A	PA Qtrly Report Revenue Form	PA Quarterly Report Revenue draft.png		Yes	Yes	Fillable Fileable Signable
Form	N/A	PA Qtrly Report Disbursements Form	PA Quarterly Report Disbursements draft.png		Yes	Yes	Fillable Fileable Signable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 356	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 75 %

	Requested	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	1,424	-44	1,468
Annual IC Time Burden (Hours)	11,392	-352	11,744
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.