Information Collection

Demographic Questionnaire

IC 234151 under ICR 201811-2127-007 · OMB 2127-0741.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0741 can be found here:

Documents and Forms

Document Name Document Type
Form NHTSA Form 1426 Demographic Questionnaire Form
NHTSA Form 1426 Demographic Questionnaire Revised Demographic Questionnaire_8-6-18 (003).docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Demographic Questionnaire	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	NHTSA Form 1426	Demographic Questionnaire	Revised Demographic Questionnaire_8-6-18 (003).docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 175	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	175	175
Annual IC Time Burden (Hours)	29	29
Annual IC Cost Burden (Dollars)	0	0

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.