Information Collection

Head-Up Displays and Distraction and Distraction Potential - Participant Study Visit Forms

IC 222754 under ICR 201707-2127-002 · OMB 2127-0732.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0732 can be found here:

Documents and Forms

Document Name Document Type
Form NHTSA FORM 1346 Head-Up Displays and Distraction and Distraction Potential - Participant Study Visit Forms Form
NHTSA FORM 1346 Demographic Questionnaire 6. Demographic Questionnaire_nhtsa.docx Form
NHTSA FORM 1347 Informed Consent 8. Informed Consent.doc Form
NHTSA FORM 1348 Information Sheet 7. Information Sheet.doc Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Head-Up Displays and Distraction and Distraction Potential - Participant Study Visit Forms	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	NHTSA FORM 1346	Demographic Questionnaire	6. Demographic Questionnaire_nhtsa.docx	No	Paper Only
Form	NHTSA FORM 1347	Informed Consent	8. Informed Consent.doc	No	Paper Only
Form	NHTSA FORM 1348	Information Sheet	7. Information Sheet.doc	No	Paper Only

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 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	60	60
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	433	433

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.