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Older Drivers' Self-Regulation and Exposure Consent Form
Older Drivers’ Self-Regulation and Exposure
OMB: 2127-0722
IC ID: 220193
OMB.report
DOT/NHTSA
OMB 2127-0722
ICR 201602-2127-004
IC 220193
( )
Documents and Forms
Document Name
Document Type
Form 1332
Older Drivers' Self-Regulation and Exposure Consent Form
Form and Instruction
1332 Older Drivers’ Self-Regulation and Exposure Consent Form
Appendix F Form1332 Informed Consent.doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Older Drivers' Self-Regulation and Exposure Consent Form
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 and Instruction
1332
Older Drivers’ Self-Regulation and Exposure Consent Form
Appendix F Form1332 Informed Consent.doc
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
60
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
60
0
60
0
0
0
Annual IC Time Burden (Hours)
120
0
120
0
0
0
Annual IC Cost Burden (Dollars)
2,928
0
2,928
0
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.