Information Collection

Driver Exercise and Food Consumption Questionnaire

IC 242908 under ICR 202006-0920-016 · OMB 0920-1338.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Driver Exercise and Food Consumption Questionnaire	Form and Instruction
Exercise and Food Consumption Questionnaire Att. N Exercise and Food Consumption Questionnaire.docx	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	n/a	Exercise and Food Consumption Questionnaire	Att. N Exercise and Food Consumption Questionnaire.docx		Yes	Yes	Fillable Fileable

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	360	360
Annual IC Time Burden (Hours)	120	120
Annual IC Cost Burden (Dollars)	2,580	2,580

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.