Information Collection

Surveys for Instrumented On-Road Study of Motorcycle Riders

IC 202221 under ICR 201205-2127-004 · OMB 2127-0692.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0692 can be found here:

Documents and Forms

Document Name Document Type
Form NHTSA Form 1170 Surveys for Instrumented On-Road Study of Motorcycle Riders Form and Instruction
Appendix_F_-_Question_by_Question_Justification[1].docx Instruction
NHTSA Form 1170 Screener for Instrumented On-Road Study of Motorcycle Ri Appendix_C_-_Screener[1].docx Form and Instruction
NHTSA Form 1171 Intake Questionnaire for Instrumented On-Road Study of M Appendix_D_-_Intake_Questionnaires[1].docx Form and Instruction
NHTSA Form 1172 Debriefing Questionnaire for Instrumented On-Road Study Appendix_E_-_Debriefing_Questionnaire[1].docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Surveys for Instrumented On-Road Study of Motorcycle Riders	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 1170	Screener for Instrumented On-Road Study of Motorcycle Riders	Appendix_C_-_Screener[1].docx	No	Fillable Printable
Form and Instruction	NHTSA Form 1171	Intake Questionnaire for Instrumented On-Road Study of Motorcycle Riders	Appendix_D_-_Intake_Questionnaires[1].docx	No	Fillable Printable
Form and Instruction	NHTSA Form 1172	Debriefing Questionnaire for Instrumented On-Road Study of Motorcycle Riders	Appendix_E_-_Debriefing_Questionnaire[1].docx	No	Fillable Printable
Instruction			Appendix_F_-_Question_by_Question_Justification[1].docx	No	Printable Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 160	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	320	320
Annual IC Time Burden (Hours)	240	240
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.