Information Collection

National Automotive Sampling System (NASS), Crashworthiness Data System (CDS) Interview and Occupant Information

IC 44079 under ICR 200907-2127-005 · OMB 2127-0021.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0021 can be found here:

Documents and Forms

Document Name Document Type
Form HS Form 433A National Automotive Sampling System (NASS), Crashworthiness Data System (CDS) Interview and Occupant Information Form
HS Form 433A Occupant Assessment Form Ocuppant Assessment HS Form 433A.pdf Form
HS Form 433B Occupant Assessment Form Occupant Injury HS Form 433b.pdf Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Automotive Sampling System (NASS), Crashworthiness Data System (CDS) Interview and Occupant Information	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HS Form 433A	Occupant Assessment Form	Ocuppant Assessment HS Form 433A.pdf		No		Fillable Printable
Form and Instruction	HS Form 433B	Occupant Assessment Form	Occupant Injury HS Form 433b.pdf		No		Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 13,500	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	13,500	13,500
Annual IC Time Burden (Hours)	5,807	5,807
Annual IC Cost Burden (Dollars)	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.