Pilot/Operator Aircraft Accident/Incident Report

Forms and Documents

Document Name	Status
Form NTSB 6120.1 Pilot/Operator Aircraft Accident/Incident Report Form and Instruction	Unchanged
Form 6120.1 - Approved - April 2024.docx Supplementary Document	2024-07-22
Justification for Non-Substantive Change.docx Justification for No Material/Nonsubstantive Change	2024-07-22
Revised 6120 Form.pdf Supplementary Document	2024-03-21
88 Fed Reg 86160 (Dec. 12, 2023).pdf Supplementary Document	2023-12-12
86 Fed. Reg. 23745 (May 4, 2021).pdf Supplementary Document	2023-11-17
NTSB Form 6120.1 ROCIS.docx Supplementary Document	2023-11-17
Supporting Statement B ROCIS 4.24.24.docx Supporting Statement B	2024-04-24
Supporting Statement A ROCIS 4.24.24.docx Supporting Statement A	2024-04-24

IC Document Collections

IC ID	Document Title	Status
209596	Pilot/Operator Aircraft Accident/Incident Report Form and Instruction	Unchanged

ICR Details

OMB Control No: 3147-0001	ICR Reference No: 202407-3147-001
Status: Received in OIRA	Previous ICR Reference No: 202001-3147-001
Agency/Subagency: NTSB	Agency Tracking No: 6120.1
Title: Pilot/Operator Aircraft Accident/Incident Report
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 07/22/2024

	Requested	Previously Approved
Expiration Date	04/30/2027	04/30/2027
Responses	1,400	1,400
Time Burden (Hours)	1,400	1,400
Cost Burden (Dollars)	0	0

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Abstract: The pilot/operator accident and incident report form is an information collection tool. The form is completed by the pilot, the operator, or their representative who was involved in an accident or incident. The pilot/operator acquires and submits the form by email, mail, or fax. The form is available at https://www.ntsb.gov/Pages/Report.aspx.

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Authorizing Statute(s): US Code: 49 USC 1101-1155 Name of Law: Independent Bd Safety Act of 1974; National Transportation Safety Board Reauthorization Act of 2006
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 23745	05/04/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 86160	12/12/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Pilot/Operator Aircraft Accident/Incident Report	NTSB 6120.1	Pilot/Operator Aircraft Accident Incident Report

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ICR Summary 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	1,400	1,400	0	0	0	0
Annual Time Burden (Hours)	1,400	1,400	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Accidents/incidents have declined.

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Annual Cost to Federal Government: $222,390

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/22/2024

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