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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.