Information Collection

National Survey of Principal Drivers of Vehicles with Rear SBRS

IC 207779 under ICR 201307-2127-004 · OMB 2127-0696.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1218 National Survey of Principal Drivers of Vehicles with Rear SBRS	Form
NHTSA Form 1218 Final Rear SBRS Questionnaire Rear_SBRS_Qx_2014_clean_Final_2.pdf	Form
FR78 5865.60DayNotice RearSeatBeltReminder ICR1 28 13.pdf Rear Seat Belt Reminder Survey	IC Document
FR78 40823.30DayNoticeRSBRSurvey7.8.13.pdf Rear Seat Belt Reminder Survey	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 1320.6

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NHTSA Form 1218	Final Rear SBRS Questionnaire	Rear_SBRS_Qx_2014_clean_Final_2.pdf		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,500

Number of Respondents for Small Entity: 1

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	2,500	2,500
Annual IC Time Burden (Hours)	667	667
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Rear Seat Belt Reminder Survey	FR78 5865.60DayNotice RearSeatBeltReminder ICR1 28 13.pdf	08/09/2013
Rear Seat Belt Reminder Survey	FR78 40823.30DayNoticeRSBRSurvey7.8.13.pdf	08/09/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.