Information Collection

Medical Review Guidelines and Medical Advisory Board Practices

IC 211232 under ICR 201404-2127-004 · OMB 2127-0705.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1228 Medical Review Guidelines and Medical Advisory Board Practices	Form and Instruction
NHTSA Form 1228 DRIVER MEDICAL REVIEW PRACTICES DTNH2209D00135TO8_Survey - v1 0 1.docx	Form and Instruction

IC Title:

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 1228	DRIVER MEDICAL REVIEW PRACTICES	DTNH2209D00135TO8_Survey - v1 0 1.docx		No		Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

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	51	51
Annual IC Time Burden (Hours)	255	255
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.