Information Collection

Countermeasures That Work

IC 221740 under ICR 201704-2127-001 · OMB 2127-0727.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0727 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA 1433 Countermeasures That Work	Form and Instruction
NHTSA 1433 Countermeasures That Work End User Survey Appendix C-1 - Form 1343 CMTW.docx	Form and Instruction

IC Title:

Countermeasures That Work

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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 and Instruction	NHTSA 1433	Countermeasures That Work End User Survey	Appendix C-1 - Form 1343 CMTW.docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 50

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	50	50
Annual IC Time Burden (Hours)	75	75
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.