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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.