Information Collection

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

IC 44079 under ICR 201401-2127-001 · OMB 2127-0021.

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 HS Form 433A.doc	Form
HS Form 433B Occuoant Injury Form HS Form 433B.doc	Form and Instruction
HS Form 433D Interview Form (A) HS Form 433D.doc	Form and Instruction

IC Title:

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	Available Electronically?	Electronic Capability
Form	HS Form 433A	Occupant Assessment Form	HS Form 433A.doc	No	Fillable Printable
Form and Instruction	HS Form 433B	Occuoant Injury Form	HS Form 433B.doc	No	Fillable Printable
Form and Instruction	HS Form 433D	Interview Form (A)	HS Form 433D.doc	No	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 9,971

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	9,971	9,971
Annual IC Time Burden (Hours)	5,605	5,605
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.