Information Collection

FARS EDT Manual Case Entry (supporting case materials)

IC 254608 under ICR 202512-2127-003 · OMB 2127-0006.

Documents and Forms

Document Name Document Type
Form NHTSA Form 1667 FARS Data Entry Form FARS EDT Manual Case Entry (supporting case materials) Form
NHTSA Form 1667 FARS Data Entry Form FARS Data Entry Form_ clean.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	FARS EDT Manual Case Entry (supporting case materials)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NHTSA Form 1667	FARS Data Entry Form	FARS Data Entry Form_ clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 22	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion	Change Due to Potential Violation of the PRA
Annual Number of Responses for this IC	19,944	1,944	18,000
Annual IC Time Burden (Hours)	59,832	23,832	36,000
Annual IC Cost Burden (Dollars)	0	0	0

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.

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