Information Collection

Credit Value Reporting Template

IC 249174 under ICR 202109-2127-001 · OMB 2127-0019.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0019 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1621 Credit Value Reporting Template	Form and Instruction
NHTSA Form 1621 Credit Value Template Credit Value Template V1.2.xlsm	Form and Instruction
NHTSA Form 1621 Credit Value Template Credit Value Template V1.2.xlsm	Form and Instruction

IC Title:

Credit Value Reporting Template

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Mandatory

CFR Citation: 49 CFR 536 49 CFR 537

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 1621	Credit Value Template	Credit Value Template V1.2.xlsm		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 11

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	11	11
Annual IC Time Burden (Hours)	550	550
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.