Information Collection Request

Crash Injury Research and Engineering Network Data Collection

ICR 202407-2127-001 · OMB unassigned · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
30 day notice pdf.pdf Supplementary Document Uploaded 2024-09-03 Repair queued
Form 1796 UMD CIREN Assent form pedestrian.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1795 UMD CIREN Consent form patient pedestrian.pdf Supplementary Document Uploaded 2024-08-22 Missing upstream
Form 1794 UMD CIREN Consent form patient occupant.pdf Supplementary Document Uploaded 2024-08-22 Missing upstream
Form 1793 UAB CIREN Assent form child.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1792 UAB CIREN Consent form child patient.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1791 UAB CIREN Consent form adult patient.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1790 Inova CIREN Consent form patient WMC.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1789 Inova CIREN Consent form vehicle UVA.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1788 Inova CIREN Assent form UVA.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1787 Inova CIREN Consent form patient UVA.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1786 Inova CIREN Consent form vehicle IFH.docx Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1785 Inova CIREN Assent form IFH.docx Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1784 Inova CIREN Consent form patient IFH.docx Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1783 WFU CIREN Informed consent vehicle AHCMC.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1782 WFU CIREN Informed consent vehicle AHCMC.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1781 WFU CIREN Informed consent vehicle Spanish WFUHS.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1780 WFU CIREN Informed consent vehicle WFUHS.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1779 WFU CIREN Informed consent subject Spanish AHCMC.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1778 WFU CIREN Informed consent subject AHCMC.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1777 WFU CIREN Informed consent subject Spanish WFUHS.pdf Supplementary Document Uploaded 2024-08-22 Missing upstream
Form 1776 WFU CIREN Informed consent subject WFUHS.pdf Supplementary Document Uploaded 2024-08-22 Missing upstream
Form 1775 Emory CIREN Photo release.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1774 Emory CIREN Consent for vehicle inspection.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1773 Emory CIREN Assent form for minor subjects.pdf Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1772 Emory CIREN Consent to be a research subject.pdf Supplementary Document Uploaded 2024-08-22 Missing upstream
Form 1771 CIREN Pedestrian Interview Form 20230830.docx Supplementary Document Uploaded 2024-08-22 Repair queued
Form 1770 CIREN Occupant Interview Form 20230830.docx Supplementary Document Uploaded 2024-08-22 Missing upstream
PartB_OMB_package for CIREN 20240528 clean.docx Supporting Statement B Uploaded 2024-08-22 Repair queued
PartA_OMB_package_supporting_statement for CIREN 20240528 clean.docx Supporting Statement A Uploaded 2024-08-22 Repair queued
60 day notice pdf.pdf Supplementary Document Uploaded 2024-07-05 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
270330 Access to Towing/Salvage Facility Other-Summary of Information Collection New
270329 Vehicle Insurance Permission Other-Summary of Information Collection New
270327 EMS Report Requests Other-Summary of Information Collection New
270325 Police Report Requests Other-Summary of Information Collection New
270323 Case Subject Interview Other-Summary of Information Collection New
270319 Potential Case Subject Consent Other-Summary of Information Collection New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
1,652 0
1,059 0
0 0





Reginfo record details
6
table that charts list of burden
IC Title Form No. Form Name
Access to Towing/Salvage Facility
Case Subject Interview
EMS Report Requests
Police Report Requests
Potential Case Subject Consent
Vehicle Insurance Permission

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,652 0 0 1,652 0 0
Annual Time Burden (Hours) 1,059 0 0 1,059 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No