Information Collection

NHTSA 2009 Distracted Driving Survey Project

IC 191324 under ICR 201405-2127-004 · OMB 2127-0665.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1084 NHTSA 2009 Distracted Driving Survey Project	Form
NHTSA Form 1084 Distracted Driving Intercept Survey Appendix C Distracted Driving Intercept Survey Revised-3-13-2013 (3).docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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 1084	Distracted Driving Intercept Survey	Appendix C Distracted Driving Intercept Survey Revised-3-13-2013 (3).docx		No		Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 22,200

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	Previously Approved
Annual Number of Responses for this IC	22,200	22,200
Annual IC Time Burden (Hours)	1,850	1,850
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.