Information Collection

Assessment and Delivery of Safety Funding at the Local Level

IC 203009 under ICR 201207-2125-001 · OMB 2125-0634.

Documents and Forms

Document Name Document Type
Local Level Final Questionnaire_5-24-12.docx Other-Questionaire

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Assessment and Delivery of Safety Funding at the Local Level	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Questionaire			Local Level Final Questionnaire_5-24-12.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 50	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	50	50
Annual IC Time Burden (Hours)	250	250
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.