View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Assessment of Characteristics of State Crash Outcome Data Evaluation Systems
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-0879 Yes Yes Fillable Printable
Form and Instruction 0920-0879 Yes Yes Fillable Fileable
Instruction Yes Yes Printable Only
Form and Instruction 0920-0879 No No Printable Only
Form and Instruction 0920-0879 Yes Yes Fillable Printable

Health Consumer Health and Safety

 

35 0
   
State, Local, and Tribal Governments
 
   100 %

  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 35 0 35 0 0 0
Annual IC Time Burden (Hours) 18 0 18 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A 11/13/2012
Supporting Statement B 11/13/2012
Attachmen C - sample ED record 11/13/2012
Attachment A NHTSA 2010 Traffic Safety Facts 11/13/2012
Attachment B Police crash report 11/13/2012
Attachment D - sample inpatient record 11/13/2012
Attachment E - Motor_Vehicle_WB_Letter 11/13/2012
Attachment F RFP for CODES 11/13/2012
Attachment G - Oriiginal multi state report 11/13/2012
Attachment H catalog of CODES projects 11/13/2012
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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