OMB control number

Air Force Safety Automated System (AFSAS) Preliminary Mishap/Incident Reporting

OMB 0701-0164 · DOD/AF.

OMB 0701-0164

Information is collected of those Air Force & DoD personnel involved in mishaps and witnesses (could be members of the general public) to include names, age, and medical information (Injury Severity, Injured Body Part, and Injury Type). Information is collected for the purpose of reporting mishaps, and to have valid and reliable data in order to determine safety trends, implement the ORM process, prevent mishaps, preserve AF assets, and to save lives.

The latest form for Air Force Safety Automated System (AFSAS) Preliminary Mishap/Incident Reporting expires 2023-08-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form AF 978 Supervisor's Preliminary Mishap/Incident Report Form
0701-0164_PIA_8.14.2020.pdf Supplementary Document
0701-0164_DraftSORN_5.10.2019.docx Supplementary Document
0701-0164_SSA_8.25.2023.docx Supporting Statement A
Supervisor's Preliminary Mishap/Incident Report Form

All Historical Document Collections

202308-0701-003 Approved with change	Extension without change of a currently approved collection	2023-08-31
202002-0701-001 Approved without change	New collection (Request for a new OMB Control Number)	2020-07-14