Physical Fitness and Driving Performance

Forms and Documents

Document Name	Status
Form NHTSA Form 1227 Physical Fitness and Driving Performance Form	New
2015.08.14 Fitness_ Appendix B_ justification for instruments_FINAL_KS.docx Supplementary Document	2015-09-14
Appendix B - Justification for questionnaire items.docx Supplementary Document	2014-10-10
Appendix A - Authority.docx Supplementary Document	2014-10-10
30-day notice.pdf Supplementary Document	2014-10-10
60-day 2013-27400.pdf Supplementary Document	2014-10-10
2015.08.14 OMB Section B_PhysFit_FINAL_KS.docx Supporting Statement B	2015-09-14
2015.08.14 OMB Section A_PhysFit_FINAL_KS.docx Supporting Statement A	2015-09-14

IC Document Collections

IC ID	Document Title	Status
213470	Physical Fitness and Driving Performance Form	New

ICR Details

OMB Control No: 2127-0711	ICR Reference No: 201410-2127-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOT/NHTSA	Agency Tracking No:
Title: Physical Fitness and Driving Performance
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/18/2015
	Date Received in OIRA: 02/27/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2018	36 Months From Approved
Responses	270	0	0
Time Burden (Hours)	495	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The National Highway Traffic Safety Administration (NHTSA) of the U.S. Department of Transportation (USDOT) is seeking approval from the Office of Management and Budget (OMB) to conduct a qualifying interview with prospective participants in a study about the effects of physical activity and fitness on driving performance. The project will explore relationships between older adult activity level and specific driving tasks, relationships between different activity types (e.g., aerobic or strength training) and specific driving task performance. The information from this qualifying interview will be used by NHTSA to determine eligibility for study participation.

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Authorizing Statute(s): US Code: 23 USC 403 Name of Law: Highway Safety Research and Development
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 221	11/15/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 84	05/01/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Physical Fitness and Driving Performance	NHTSA Form 1277, NHTSA Form 1281, NHTSA Form 1227	Recruitment Form ,   Adult Consent Form ,   Adult Consent-Driving

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	270	0	0	270	0	0
Annual Time Burden (Hours)	495	0	0	495	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection. As such, it requires a program change to add the estimated 495 hours for the new information collection to existing burden.

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Annual Cost to Federal Government: $117,824

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/27/2015

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