Information Collection

Appendix B - Online Survey Pre-Screener

IC 236370 under ICR 201905-2127-007 · OMB 2127-0745.

Documents and Forms

Document Name Document Type
Form NHTSA 1393 Appendix B - Online Survey Pre-Screener Form
NHTSA 1393 Appendix B - Online Survey Pre-Screened Appendix B - Online Survey Pre-Screener_OMB_9.4.2019_Clean.docx Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Appendix B - Online Survey Pre-Screener	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 1393	Appendix B - Online Survey Pre-Screened	Appendix B - Online Survey Pre-Screener_OMB_9.4.2019_Clean.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18,520	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	18,520	18,520
Annual IC Time Burden (Hours)	463	463
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.