Information Collection

Neighborhood Environmental Survey - Telephone questionnaire

IC 213121 under ICR 201804-2120-014 · OMB 2120-0762.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix I - Telephone Questionnaire_rev_clean.docx	Other-Telephone questionnaire questi

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Other-Telephone questionnaire question list					No		Paper Only

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,140

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	2,140	2,140
Annual IC Time Burden (Hours)	713	713
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.

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