Information Collection

Tombras - NHTSA Segmentation Profiling Questionnaire

IC 44549 under ICR 200608-2127-001 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA 1014 Tombras - NHTSA Segmentation Profiling Questionnaire	Form
NHTSA 1014 Tombras - NHTSA Segmentation Profiling Questionnaire VJackson Emergency Survey.DOC	Form

IC Title:

Agency IC Tracking Number:

ICBID 9347

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NHTSA 1014	Tombras - NHTSA Segmentation Profiling Questionnaire	VJackson Emergency Survey.DOC		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction:

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 800

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	267	267
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.