Information Collection

Survey Packet, Travel Diary & Phone Interview

IC 198184 under ICR 201111-2125-001 · OMB 2125-0630.

Documents and Forms

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Travel Diary	1107 main study travel diary 062111.doc	No	Paper Only
Other-Worksheet	1107 main study worksheets 6-24-11.doc	No	Paper Only
Instruction	1107 main study cover letter 062111.docx	No	Paper Only
Other-Phone Interview	1107_Final_Main_Quex_11-1-11[1].docx	No	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

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
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	1,200	1,200
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.