Information Collection

Debreifing Questionnaire

IC 228904 under ICR 201710-2126-003 · OMB 2126-0066.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Driver Form 6 Debreifing Questionnaire	Form
Driver Form 6 Driver Debriefing Questionnaire Sleeper Berth Pilot Program Debriefing Questionnaire.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	Driver Form 6	Driver Debriefing Questionnaire	Sleeper Berth Pilot Program Debriefing Questionnaire.docx		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 160

Number of Respondents for Small Entity: 25

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

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	160	160
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	1,215	1,215

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.