Pilot/Operator Aircraft Accident/Incident Report

ICR 200107-3147-001

OMB: 3147-0001

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
33092 Migrated
ICR Details
3147-0001 200107-3147-001
Historical Active 199307-3147-001
NTSB
Pilot/Operator Aircraft Accident/Incident Report
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 08/27/2001
Retrieve Notice of Action (NOA) 07/25/2001
  Inventory as of this Action Requested Previously Approved
08/31/2004 08/31/2004
2,100 0 0
2,100 0 0
0 0 0

The Form 6120.1 is used by pilots or operators of all aircraft involved in a reportable occurrence. Completion of this form fulfills the pilot/operator's responsibility under 49 CFR 830. The information obtained from this form is included in the official Safety Board record of the investigation and is used by the Board to assist in the determination of probable cause.

None
None


No

1
IC Title Form No. Form Name
Pilot/Operator Aircraft Accident/Incident Report FORM-6120.1

  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 2,100 0 0 2,100 0 0
Annual Time Burden (Hours) 2,100 0 0 2,100 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.
07/25/2001


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