Pilot/Operator Aircraft Accident/Incident Report

Forms and Documents

Document Name	Status
Form 6120.1 Pilot/Operator Aircraft Accident/Incident Report Form	Modified
6120_1_WEB_PrintOnly.pdf Supplementary Document	2010-03-15
6120_1_WEB_fillable_savable.pdf Supplementary Document	2010-03-15
6120-1 Supporting Statement aviation.doc Supporting Statement A	2010-03-15

IC Document Collections

IC ID	Document Title	Status
33094	Pilot/Operator Aircraft Accident/Incident Report Form	Modified

ICR Details

OMB Control No: 3147-0001	ICR Reference No: 201002-3147-001
Status: Historical Active	Previous ICR Reference No: 200603-3147-001
Agency/Subagency: NTSB	Agency Tracking No: 6120.1
Title: Pilot/Operator Aircraft Accident/Incident Report
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/26/2010
	Date Received in OIRA: 03/16/2010
Terms of Clearance: Any collection of information under OMB Control Number 3147-0001 between 6/30/2009 and the conclusion date of this action (approxiamately 11/30/2010) is in violation of the Paperwork Reduction Act. This information collection is given a shortened approval date (9/2011), since it appears to be associated with a rulemaking action yet is not classified as such. Upon resubmission, the package should include reference to rulemaking actions affecting this collection of information.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2011	36 Months From Approved
Responses	2,200	0	0
Time Burden (Hours)	2,200	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The pilot accident report form is an accident information collect collection tool. The form is completed by the accident pilot, the opeerator, or their representative. It is acquied by mail or fax.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 58520	10/07/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 922	01/07/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

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

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ICR Summary of Burden

	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	2,200	0	0	100	0	2,100
Annual Time Burden (Hours)	2,200	0	0	100	0	2,100
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: NTSB's final rule included revisions to subsections of 49 CFR 830.5, including subsection (a)(8), (a)(9), (a)(10), (a)(11) and (a)(12),which proposed requiring reports of release of all or a portion of a propeller blade from an aircraft excluding release caused solely by ground contact; a complete loss of information from certain electrnic displays; certain types of resolution advisories; damage to helicopter tail or main rotor blades, including ground dame that requires major repair or replacement of the blade(s); and certain runway incursions, respectively. The NTSB estimates that an additional 100 respondents will be required to report information as a result of these changes.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 03/16/2010

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