Incident Reporting for Automated Driving Systems (ADS) and Level 2 Advanced Driver Assistance Systems (ADAS)

ICR 202212-2127-004

OMB: 2127-0754

Federal Form Document

Forms and Documents

Document Name	Status
Form NHTSA Form 1612 Level 2 ADAS/ADS Incident Reporting Form and Instruction	Unchanged
Form NHTSA Form 1612 Monthly Reports Form	Removed
Form NHTSA Form 1612 ADS one-day reports, update Form	Removed
Form NHTSA Form 1612 ADS one-day reports, initial Form	Removed
Form NHTSA Form 1612 Level 2 ADAS one-day reports, update Form	Removed
Form NHTSA Form 1612 Level 2 ADAS one-day reports, initial Form	Removed
PRA SS Part A ADS ADAS Incident Reporting_30Day_12.23.21_final (1).docx Supporting Statement A	2022-12-19
First_Amended_SGO_2021_01_Final.pdf Supplementary Document	2021-12-29
60 Day Notice_9.30.12_86 FR 54287.pdf Supplementary Document	2021-12-29
30 Day Notice_12.29.21_86 FR 74217.pdf Supplementary Document	2021-12-29

IC Document Collections

IC ID	Document Title	Status
250893	Level 2 ADAS/ADS Incident Reporting Form and Instruction	Unchanged
248104	Setting Up MAP Account	Removed
248103	Training	Removed
248102	Monthly Reports Form	Removed
248101	ADS one-day reports, update Form	Removed
248100	ADS one-day reports, initial Form	Removed
248099	Level 2 ADAS one-day reports, update Form	Removed
248098	Level 2 ADAS one-day reports, initial Form	Removed