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Motor Vehicle Occupant Safety Survey
Motor Vehicle Occupant Safety Survey
OMB: 2127-0645
IC ID: 26354
OMB.report
DOT/NHTSA
OMB 2127-0645
ICR 201406-2127-006
IC 26354
( )
Documents and Forms
Document Name
Document Type
Form NHTSA FORM 1020
Motor Vehicle Occupant Safety Survey
Form and Instruction
NHTSA FORM 1020 Welcome Page
Welcome Screen For Entry To Questionnaire.docx
Form and Instruction
NHTSA Form 1020A Version A Questionnaire
Version A MVOSS (1) Questionnaire.doc
Form
NHTSA FORM 1020B Version B Questionnaire
Version B MVOSS (1) Questionnaire.doc
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Motor Vehicle Occupant Safety Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Form and Instruction
NHTSA FORM 1020
Welcome Page
Welcome Screen For Entry To Questionnaire.docx
TBD
Yes
Yes
Fillable Fileable
Form
NHTSA Form 1020A
Version A Questionnaire
Version A MVOSS (1) Questionnaire.doc
TBD
Yes
Yes
Fillable Fileable
Form
NHTSA FORM 1020B
Version B Questionnaire
Version B MVOSS (1) Questionnaire.doc
TBD
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
12,000
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
50 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
12,000
0
12,000
0
0
0
Annual IC Time Burden (Hours)
3,000
0
3,000
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.