Information Collection

Study Subset for Additional Collection

IC 233941 under ICR 201811-2127-003 · OMB 2127-0742.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1466 Study Subset for Additional Collection	Form and Instruction
1466 Sleep diary Form1466-PaperSleepDiary.docx	Form and Instruction
1467 Psychomotor Vigilance Test Form1467-Psychomotor Vigilance Testing.pptx.pdf	Form and Instruction

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 and Instruction	1466	Sleep diary	Form1466-PaperSleepDiary.docx		No		Paper Only
Form and Instruction	1467	Psychomotor Vigilance Test	Form1467-Psychomotor Vigilance Testing.pptx.pdf		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 30

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	30	30
Annual IC Time Burden (Hours)	124	124
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.