OMB
.report
Search
ADS one-day reports, update
Incident Reporting for Automated Driving Systems (ADS) and Level 2 Advanced Driver Assistance Systems (ADAS)
OMB: 2127-0754
IC ID: 248101
OMB.report
DOT/NHTSA
OMB 2127-0754
ICR 202212-2127-004
IC 248101
( )
Documents and Forms
Document Name
Document Type
Form NHTSA Form 1612
ADS one-day reports, update
Form
NHTSA Form 1612 ADS ADAS Incident Report
[STATIC IMAGE + WATERMARK] - NHTSA Form 1612 - ADS ADAS Incident Report Form.png
Form
NHTSA Form 1612 ADS ADAS Incident Report
[STATIC IMAGE + WATERMARK] - NHTSA Form 1612 - ADS ADAS Incident Report Form.png
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
ADS one-day reports, update
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
Obligation to Respond:
Mandatory
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 1612
ADS ADAS Incident Report
[STATIC IMAGE + WATERMARK] - NHTSA Form 1612 - ADS ADAS Incident Report Form.png
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
10
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
0
0
0
-10
0
10
Annual IC Time Burden (Hours)
0
0
0
-10
0
10
Annual IC Cost Burden (Dollars)
0
0
0
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.