Information Collection

State DOT Respondents

IC 209648 under ICR 201806-2125-001 · OMB 2125-0638.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2125-0638 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FHWA-JL0001 State DOT Respondents	Form and Instruction
FHWA-JL0001 Jasons Law Survey Jason's Law 2018 Survey Plan rev 6-6-18.docx	Form and Instruction

IC Title:

State DOT Respondents

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
Form and Instruction	FHWA-JL0001	Jasons Law Survey	Jason's Law 2018 Survey Plan rev 6-6-18.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 17

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	17	17
Annual IC Time Burden (Hours)	67	67
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.