NASA SAFETY REPORTING SYSTEM (NSRS)

ICR 198706-2700-003

OMB: 2700-0063

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
146388
Migrated
ICR Details
2700-0063 198706-2700-003
Historical Active
NASA
NASA SAFETY REPORTING SYSTEM (NSRS)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/03/1987
Retrieve Notice of Action (NOA) 06/11/1987
Three-year approval period will allow adequate time for a more accurate estimate of burden hours.
  Inventory as of this Action Requested Previously Approved
09/30/1990 09/30/1990
10 0 0
10 0 0
0 0 0

FORM WILL BE USED BY NASA EMPLOYEES AND NASA CONTRACTOR EMPLOYEES TO VOLUNTARILY AND CONFIDENTIALLY REPORT TO AN INDEPENDENT AGENT ANY SAFETY CONCERNS OR HAZARDS PERTAINING TO THE NATIONAL SPACE TRANSPORTATION SYSTEM (NSTS).

None
None


No

1
IC Title Form No. Form Name
NASA SAFETY REPORTING SYSTEM (NSRS)

  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 10 0 0 10 0 0
Annual Time Burden (Hours) 10 0 0 10 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

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.
06/11/1987


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