Information Collection

Advanced Crash Technologies Qualitative Research

IC 206671 under ICR 201403-2127-001 · OMB 2127-0698.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1195 Advanced Crash Technologies Qualitative Research	Form
NHTSA Form 1195 Appendix A - Advanced Crash Technologies Qualitative Scr Appendix_A_Advanced_Crash_Technologies_Qualitative_Screener_2102014[1].docx	Form
NHTSA Form 1196 Appendix B - Advanced Crash Technologies Discussion Guid Appendix_B_Advanced_Crash_Technologies_Discussion_Guide_2102014[1].docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

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 1195	Appendix A - Advanced Crash Technologies Qualitative Screener	Appendix_A_Advanced_Crash_Technologies_Qualitative_Screener_2102014[1].docx		No		Fillable Fileable
Form and Instruction	NHTSA Form 1196	Appendix B - Advanced Crash Technologies Discussion Guide	Appendix_B_Advanced_Crash_Technologies_Discussion_Guide_2102014[1].docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 132

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	212	212
Annual IC Time Burden (Hours)	170	170
Annual IC Cost Burden (Dollars)	3,600	3,600

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.