Demographic Survey

National Traffic Incident Management (TIM) Responder Training Program

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2125-0650 can be found here:

Documents and Forms

Document Name Document Type
Form FHWA TIM-5 Demographic Survey Form
FHWA TIM-5 Demographic Survey L32C TIM Trng PCAT Demographic Questions - 012215 Final Draft.docx Form

Information Collection (IC) Details

IC Title:	Demographic Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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	FHWA TIM-5	Demographic Survey	L32C TIM Trng PCAT Demographic Questions - 012215 Final Draft.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 12,200	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12,200	12,200
Annual IC Time Burden (Hours)	407	407
Annual IC Cost Burden (Dollars)	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.