Information Collection

Click It or Ticket Next Generation Surveys

IC 180957 under ICR 200706-2127-005 · OMB 2127-0646.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0646 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA 1012 Click It or Ticket Next Generation Surveys	Form
NHTSA 1012 Virginia Seat Belt Survey VA Survey.doc	Form
NHTSA 1012 Iowa Seat Belt Survey IA Survey.doc	Form
NHTSA 1012 Pennsylvania Seat Belt Survey PA Survey.doc	Form

IC Title:

Click It or Ticket Next Generation Surveys

Agency IC Tracking Number:

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NHTSA 1012	Iowa Seat Belt Survey	IA Survey.doc	Yes	Yes	Fillable Fileable
Form	NHTSA 1012	Pennsylvania Seat Belt Survey	PA Survey.doc	Yes	Yes	Fillable Fileable
Form	NHTSA 1012	Virginia Seat Belt Survey	VA Survey.doc	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 10,000

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 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	10,000	0	0	0	0	0
Annual IC Time Burden (Hours)	1,667	0	0	0	0	0
Annual IC Cost Burden (Dollars)	6,250	0	0	0	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.