Information Collection

Demographic Survey

IC 218007 under ICR 201506-2125-002 · OMB 2125-0650.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

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.