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Serious Injury Compliance Reporting
Inventory of State Compliance on Serious Injury Reporting Using the Model Minimum Uniform Crash Criteria 4th Edition
OMB: 2125-0659
IC ID: 231804
OMB.report
DOT/FHWA
OMB 2125-0659
ICR 201806-2125-002
IC 231804
( )
Documents and Forms
Document Name
Document Type
SIComplianceQuestionsrevisedFinal.docx
Other-Web Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Serious Injury Compliance Reporting
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Web Form
SIComplianceQuestionsrevisedFinal.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
75
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 New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
75
0
75
0
0
0
Annual IC Time Burden (Hours)
38
0
38
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
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.