Control Driver Verbal Consent

Crash Risk Associated with Drug and Alcohol Use by Drivers in Fatal and Serious Injury Crashes

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0744 can be found here:

Documents and Forms

Document Name Document Type
Form 1421 Control Driver Verbal Consent Form and Instruction
1421 Control Driver Verbal Consent Form 1421 Control Driver Verbal Consent Sept 2018.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Control Driver Verbal Consent	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1421	Control Driver Verbal Consent	Form 1421 Control Driver Verbal Consent Sept 2018.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 9,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	9,000	9,000
Annual IC Time Burden (Hours)	1,383	1,383
Annual IC Cost Burden (Dollars)	17,640	17,640

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.