FHWA NHTS-2 Odometer Mileage Record Form

Participation is voluntary and your information will be kept confidential. The information will be used to analyze travel behaviors of US. Public. Estimated reporting burden is 2 minutes including the time to
review instructions, search existing data sources, gather and maintain the data needed, and complete and review the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a current valid OMB control number. The OMB control number for this collection is 2125-0545. Comments or suggestions regarding any aspect
of burden, collection of information may be sent to: Michael Howell, Information Collection Clearance Officer, Federal Highway Administration, 202 366-5707, [email protected], 1200 New Jersey Avenue,
SE, Washington, DC 20590.

Odometer Mileage
Record Form
Use this form to record a one-time odometer reading for every vehicle owned, leased, or
available for regular use by the people who live in your household. Please include all household
vehicles, even if the vehicle isn’t used on your travel day. If you have no household vehicles, leave
this form blank.
Many odometers show two readings -- one shows the mileage since the vehicle was new and the other
can be reset to zero whenever you want. Be sure to write down the odometer reading that shows
the mileage for the entire life of the vehicle, not the reading that can be reset.

Vehicle
Number

Year

Make

Model

(do not include tenths of a mile)

Date of
Reading

Example

2007

Ford

Focus

118,623

06/23/2015

Odometer Reading

Vehicle 1
Vehicle 2
Vehicle 3
Vehicle 4
Vehicle 5
Vehicle 6
Vehicle 7
Vehicle 8

Be sure to keep this form handy. You will be asked to provide this information when you
complete the survey either online or by phone.
Questions? Visit www.NationalHouseholdTravelSurvey.com or call 1-855-350-6487 (NHTS).

FHWA NHTS-2

The National Household Travel Survey sponsored by FHWA, U.S. DOT.