Information Collection Request

Whistleblower Program Forms

ICR 202309-2127-001 · OMB 2127-0767 · Historical Inactive

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form NHTSA Form 1686 FORM WB-AWARD WHISTLEBLOWER AWARD APPLICATION Form and Instruction New Available
Form NHTSA Form 1686 WB-AWARD-Individual with Legal Representative Form and Instruction New Repair queued
Form NHTSA Form 1685 FORM WB-RELEASE WHISTLEBLOWER RELEASE FORM Form and Instruction New Available
Form NHTSA Form 1685 WB-RELEASE-Individual with Legal Representative Form and Instruction New Repair queued
Form NHTSA Form 1685 FORM WB-RELEASE WHISTLEBLOWER RELEASE FORM Form and Instruction New Available
Form NHTSA Form 1685 WB-RELEASE-Individual Form and Instruction New Repair queued
Form NHTSA Form 1684 FORM WB-INFO WHISTLEBLOWER SUBMISSION Form and Instruction New Available
Form NHTSA Form 1684 WB-INFO- Individual with Legal Representative Form and Instruction New Repair queued
Form NHTSA Form 1684 FORM WB-INFO WHISTLEBLOWER SUBMISSION Form and Instruction New Available
Form NHTSA Form 1684 WB-INFO-Individual Form and Instruction New Repair queued
2023-09-07 PRA Supporting Statement.Clean.docx Supporting Statement A Uploaded 2023-10-12 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
262370 WB-AWARD-Individual with Legal Representative Form and Instruction NewFORM WB-AWARD WHISTLEBLOWER AWARD APPLICATION
262370 WB-AWARD-Individual with Legal Representative Form and Instruction New
262369 WB-RELEASE-Individual with Legal Representative Form and Instruction NewFORM WB-RELEASE WHISTLEBLOWER RELEASE FORM
262369 WB-RELEASE-Individual with Legal Representative Form and Instruction New
262368 WB-RELEASE-Individual Form and Instruction NewFORM WB-RELEASE WHISTLEBLOWER RELEASE FORM
262368 WB-RELEASE-Individual Form and Instruction New
262367 WB-INFO- Individual with Legal Representative Form and Instruction NewFORM WB-INFO WHISTLEBLOWER SUBMISSION
262367 WB-INFO- Individual with Legal Representative Form and Instruction New
262366 WB-INFO-Individual Form and Instruction NewFORM WB-INFO WHISTLEBLOWER SUBMISSION
262366 WB-INFO-Individual Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0





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table that charts list of burden
IC Title Form No. Form Name
WB-AWARD-Individual with Legal Representative NHTSA Form 1686
WB-INFO- Individual with Legal Representative NHTSA Form 1684
WB-INFO-Individual NHTSA Form 1684
WB-RELEASE-Individual NHTSA Form 1685
WB-RELEASE-Individual with Legal Representative NHTSA Form 1685



Reginfo record details
  No