Information Collection

NASA Aviation Safety Reporting System (ASRS) and Related Voluntary Safety Reporting System (VSRS)

IC 236350 under ICR 201906-2700-001 · OMB 2700-0172.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2700-0172 can be found here:

Documents and Forms

Document Name Document Type
Form ARC 277# NASA Aviation Safety Reporting System (ASRS) and Related Voluntary Safety Reporting System (VSRS) Form
NASA ASRS ERS screeenshot_june232019.pptx asrs.arc.nasa.gov Other-ASRS screenshots
NASA C3RS ERS screenshots.pptx c3rs.arc.nasa.gov Other-C3RS screenshots
ARC 277B ASRS General Form ASRS form- General_051419.pdf asrs.arc.nasa.gov Form
ARC 277# Rotary Wing ASRS_RotaryWing_PRAb.pdf asrs.arc.nasa.gov Form
ARC 277# UAS ASRS UAS_2019-06-21.pdf asrs.arc.nasa.gov Form
ARC 277A ATC controller_July 2017_PRA.pdf asrs.arc.nasa.gov Form
ARC 277D Maintenance mechanic_July2017_PRA.pdf asrs.arc.nasa.gov Form
ARC 277C Cabin Crew cabin_July2017_PRA.pdf asrs.arc.nasa.gov Form
ARC 277H C3RS Engineering Form C3RS_EngineeringForm_PRA.pdf c3rs.arc.nasa.gov Form
ARC 277G C3RS Mechanical C3RS_MechanicalForm_PRA.pdf c3rs.arc.nasa.gov Form
ARC 277F C3RS Transportation C3RS_TransportationForm_PRA.pdf c3rs.arc.nasa.gov Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	NASA Aviation Safety Reporting System (ASRS) and Related Voluntary Safety Reporting System (VSRS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 14 CFR 91.25

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	ARC 277#	Rotary Wing	ASRS_RotaryWing_PRAb.pdf	https://asrs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Form	ARC 277G	C3RS Mechanical	C3RS_MechanicalForm_PRA.pdf	https://c3rs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Form	ARC 277H	C3RS Engineering Form	C3RS_EngineeringForm_PRA.pdf	https://c3rs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Form	ARC 277B	ASRS General Form	ASRS form- General_051419.pdf	https://asrs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Other-C3RS screenshots			NASA C3RS ERS screenshots.pptx	https://c3rs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Form	ARC 277C	Cabin Crew	cabin_July2017_PRA.pdf	https://asrs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Other-ASRS screenshots			NASA ASRS ERS screeenshot_june232019.pptx	https://asrs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Form	ARC 277#	UAS	ASRS UAS_2019-06-21.pdf	https://asrs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Form	ARC 277A	ATC	controller_July 2017_PRA.pdf	https://asrs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Form	ARC 277D	Maintenance	mechanic_July2017_PRA.pdf	https://asrs.arc.nasa.gov	Yes	Yes	Fillable Fileable
Form	ARC 277F	C3RS Transportation	C3RS_TransportationForm_PRA.pdf	https://c3rs.arc.nasa.gov	Yes	Yes	Fillable Fileable

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 67,173	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	67,173	67,173
Annual IC Time Burden (Hours)	33,587	33,587
Annual IC Cost Burden (Dollars)	1,807,652	1,807,652

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.