Highway Safety Questionnaire

Effects of Education on Speeding Behavior

Documents and Forms

Document Name Document Type
Form 1495 Highway Safety Questionnaire Form and Instruction
1495 Highway Safety Questionnaire 1495 Highway Safety Questionnaire 20190924.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Highway Safety 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 and Instruction	1495	Highway Safety Questionnaire	1495 Highway Safety Questionnaire 20190924.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	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	600	600
Annual IC Time Burden (Hours)	250	250
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.