Information Collection

Rear Visibility Testing Questionnaire

IC 202216 under ICR 201205-2127-003 · OMB 2127-0683.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1167 Rear Visibility Testing Questionnaire	Form
NHTSA Form 1167 Recruitment: Driving Research Study 1-2RecruitmentLetter_ResponseForm_20120613.pdf	Form
NHTSA Form 1168 Candidate Participant Screening 3_ScreeningQuestions_20120613_Pending.pdf	Form
NHTSA Form 1169 Participant Consent 4066.PIC_20120608.pdf	Form

IC Title:

Agency IC Tracking Number:

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	Available Electronically?	Electronic Capability
Form	NHTSA Form 1167	Recruitment: Driving Research Study	1-2RecruitmentLetter_ResponseForm_20120613.pdf	No	Fillable Printable
Form	NHTSA Form 1169	Participant Consent	4066.PIC_20120608.pdf	No	Fillable Printable
Form	NHTSA Form 1168	Candidate Participant Screening	3_ScreeningQuestions_20120613_Pending.pdf	No	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 590

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	590	590
Annual IC Time Burden (Hours)	117	117
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.