OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Mild Cognitive Impairment and Driving Performance

IC 213454 under ICR 201410-2127-001 · OMB 2127-0712.

Documents and Forms
Document Name
Document Type
Form
Form
Form
Information Collection (IC) Details

View Information Collection (IC)

Mild Cognitive Impairment and Driving Performance
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form NHTSA Form 1240 Recruitment Form NHTSA Form 1240 Screening quest_KS.docx Yes No Fillable Fileable
Form NHTSA Form 1286 MCI Informed Consent NHTSA Form 1286 MCI Informed Consent_KS.docx No   Fillable Fileable

Transportation Ground Transportation

 

90 0
   
Individuals or Households
 
   0 %

  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 90 0 90 0 0 0
Annual IC Time Burden (Hours) 195 0 195 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.