Information Collection

Physical Fitness and Driving Performance

IC 213470 under ICR 201410-2127-003 · OMB 2127-0711.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1227 Recruitment Form Physical Fitness and Driving Performance	Form
Form NHTSA Form 1277 Adult Consent Form Physical Fitness and Driving Performance	Form
Form NHTSA Form 1281 Adult Consent-Driving Physical Fitness and Driving Performance	Form
NHTSA Form 1227 Recruitment Form NHTSA_Form_1227[1].docx	Form
NHTSA Form 1277 Adult Consent Form NHTSA Form 1277 Driving_Fitness_Adult_Consent_4 10 14.docx	Form
NHTSA Form 1281 Adult Consent-Driving NHTSA Form 1281 Driving_Fitness_Adult_Consent_Phase 2.docx	Form

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.	Available Electronically?	Electronic Capability
Form	NHTSA Form 1227	No	Paper Only
Form	NHTSA Form 1277	No	Paper Only
Form	NHTSA Form 1281	No	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 270

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	270	270
Annual IC Time Burden (Hours)	495	495
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.

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