Information Collection

National Emergency Medical Services Information System (NEMSIS) – State Submission to National EMS Database

IC 219827 under ICR 201601-2127-004 · OMB 2127-0717.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0717 can be found here:

Documents and Forms

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Information Collection (IC) Details

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IC Title:	National Emergency Medical Services Information System (NEMSIS) â State Submission to National EMS Database	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 49 CFR 501.1

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	56	56
Annual IC Time Burden (Hours)	1,008	1,008
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.