Information Collection

Seat Belt Survey

IC 222279 under ICR 201704-2127-002 · OMB 2127-0725.

Documents and Forms

Document Name Document Type
Form 1325 Seat Belt Survey Form and Instruction
1325 Seat Belt Survey Appendix C Seat Belt Survey Form 1325 04052017.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Seat Belt Survey	Agency IC Tracking Number:	1325

Is this a Common Form? No		IC Status: Modified

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	1325	Seat Belt Survey	Appendix C Seat Belt Survey Form 1325 04052017.docx		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,400	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,400	2,400
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	9,288	9,288

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.