Information Collection

Drunk Driver Segmentation Research Plan

IC 220072 under ICR 201602-2127-003 · OMB 2127-0720.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1323 Drunk Driver Segmentation Research Plan	Form
NHTSA Form 1323 Recruitment Screener 2016_NHTSA Alcohol Screener_Questionnaire.docx	Form
NHTSA Form 1324 NHTSA: Drunk Driver/Rider Research Survey 2016_NHTSA Alcohol SURVEY.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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NHTSA Form 1323	Recruitment Screener	2016_NHTSA Alcohol Screener_Questionnaire.docx		No		Fillable Fileable
Form	NHTSA Form 1324	NHTSA: Drunk Driver/Rider Research Survey	2016_NHTSA Alcohol SURVEY.docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 22,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	22,000	22,000
Annual IC Time Burden (Hours)	5,868	5,868
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.