National Evaluation of a Mileage Based Road User Charge

National Evaluation of a Mileage-Based Road User Charge

Training Baseline Questionnaire

PAPERWORK BURDEN DISCLOSURE NOTICE

This collection of information is voluntary, and will be used to assess your acceptance of the National Evaluation of a Mileage-Based Road User Charge. Public reporting burden for this questionnaire is estimated to average between 25-45 minutes. The burden estimate includes the time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Your responses will be kept confidential to the extent permitted by law. To further protect your privacy, the researchers have obtained a Certificate of Confidentiality from the Department of Health and Human Services (DHHS). This Certificate means that the researchers cannot be forced (for example by court subpoena) to disclose information that may identify you in any federal, state, or local civil, criminal, administrative, legislative, or other proceeding. The OMB control number for this collection is 2125-XXXX (state OMB #). Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Highway Administration, 400 Seventh Street, SW, Washington, DC 20590.

For each of the following questions, please choose the statement that MOST accurately expresses your opinion.

1. Will there be a problem with paying for roads in future years?

 Yes, a big problem

 Possibly a problem in the near future

• Maybe a problem, but not for a long time

• No, not a problem

• Don’t know

2. I am concerned about the deterioration of the nation’s road system.

 Strongly agree

 Somewhat agree

• Neither agree nor disagree

• Somewhat disagree

• Strongly disagree

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3. With road-user charge statements for road use, it will be more important to get a detailed breakdown of the charges than to ensure the highest level of privacy protection.

 Strongly agree

 Somewhat agree

• Neither agree nor disagree

• Somewhat disagree

• Strongly disagree

4. Please rank the following in terms of how much you think they contribute to paying for local streets and roads (1 = biggest contributor and 4 = smallest contributor)

_____Federal funds

_____State funds

_____Local property and sales taxes

_____Land developer fees

5. How comfortable are you with the idea of a mileage-based road user system?

 Absolutely comfortable

 Mostly comfortable

• Somewhat comfortable

• Not so comfortable

• Not comfortable at all

6. Any other comments about the Road Use Study:

VERY IMPORTANT

PLEASE PROVIDE YOUR PARTICIPANT ID NUMBER BELOW. For assistance please call 866-363-1975.

PARTICIPANT ID # __________________________________________________

Thank you for completing this questionnaire.

Please return your survey to the training instructor before you leave the training session today.

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