Information Collection Request

Older Driver Rearview Video Systems

ICR 201711-2127-001 · OMB 2127-0731 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1399 Older Driver Rearview Video Systems Informed Consent Form and Instruction New Available
Form 1398 Older Driver Rearview Video Systems Screening Questions Form and Instruction New Available
Older Driver Rearview Systems ICR Section B 080318.docx Supporting Statement B Uploaded 2018-08-03 Available
Older Driver Rearview Systems ICR Section A 080318.docx Supporting Statement A Uploaded 2018-08-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
228912 Older Driver Rearview Video Systems Informed Consent Form and Instruction New
228910 Older Driver Rearview Video Systems Screening Questions Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2021 36 Months From Approved
500 0 0
360 0 0
8,943 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Older Driver Rearview Video Systems Screening Questions 1398 Screening Questions
Older Driver Rearview Video Systems Informed Consent 1399 Informed Consent

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 500 0 0 500 0 0
Annual Time Burden (Hours) 360 0 0 360 0 0
Annual Cost Burden (Dollars) 8,943 0 0 8,943 0 0


Reginfo record details
  No