Pilot/Operator Aircraft Accident/Incident Report

Forms and Documents

Document Name	Status
Form 6120.1 Pilot/Operator Aircraft Accident/Incident Report Form	Removed
Form NTSB 6120.1 NTSB Form 6120.1: Pilot/Operator Aircraft Accident/Incident Report Form and Instruction	New
Second FR Notice for 6120.1 form--11-19-13.pdf Supplementary Document	2013-11-26
First FR Notice for 6120.1 form --5-7-13.pdf Supplementary Document	2013-11-26
Supporting Statement B- NTSB Form 6120 1 11-25-13.docx Supporting Statement B	2013-11-26
Supporting Statement A- NTSB Form 6120 1 -11-26-13.docx Supporting Statement A	2013-11-26

IC Document Collections

IC ID	Document Title	Status
33094	Pilot/Operator Aircraft Accident/Incident Report Form	Removed
209596	NTSB Form 6120.1: Pilot/Operator Aircraft Accident/Incident Report Form and Instruction	New

ICR Details

OMB Control No: 3147-0001	ICR Reference No: 201311-3147-001
Status: Historical Active	Previous ICR Reference No: 201002-3147-001
Agency/Subagency: NTSB	Agency Tracking No: 6120.1
Title: Pilot/Operator Aircraft Accident/Incident Report
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/19/2014
	Date Received in OIRA: 12/05/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2017	36 Months From Approved
Responses	1,800	0	0
Time Burden (Hours)	1,800	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The pilot/operator accident and incident report form is an information collection tool. The form is completed by the pilot, the operator, or their representative who was involved in an accident or incident. The pilot/operator acquires and submits the form by email, mail, or fax. The form is available at www.ntsb.gov.

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Authorizing Statute(s): US Code: 49 USC 1101-1155 Name of Law: Independent Bd Safety Act of 1974; National Transportation Safety Board Reauthorization Act of 2006
  

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:
	78 FR 26659	05/07/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 69456	11/19/2013
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
NTSB Form 6120.1: Pilot/Operator Aircraft Accident/Incident Report	NTSB 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	1,800	0	0	0	-400	2,200
Annual Time Burden (Hours)	1,800	0	0	0	-400	2,200
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: The frequency of aircraft accidents and incidents is highly unpredictable. In prior years, the NTSB received approximately 2,200 reports of accidents or incidents via NTSB Form 6120.1. OIRA approved NTSB Form 6120.1 for receipt of 2,200 responses per year. However, in recent years, the annual number of respondents has decreased to approximately 1,800. Hence, the NTSB has decreased the burden for which it now requests approval.

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Annual Cost to Federal Government: $651,103

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]? No

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: 12/05/2013

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