Information Collection

Eligible Respondents Who Report Harrassment or Assault

IC 240695 under ICR 202111-2126-004 · OMB 2126-0071.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Form 2 Eligible Respondents Who Report Harrassment or Assault	Form and Instruction
Form 2 Survey on Crime Prevention for Truckers TruckerCrimesQuestions.docx	Form and Instruction
Form 2 Survey on Crime Prevention for Truckers TruckerCrimesQuestions.docx	Form and Instruction
Form 2 Survey on Crime Prevention for Truckers TruckerCrimesQuestions - question 40 added CLEAN.docx	Form and Instruction
Form 2 Survey on Crime Prevention for Truckers TruckerCrimesQuestions - question 40 added CLEAN.docx	Form and Instruction
Form 2 Survey on Crime Prevention for Truckers TruckerCrimesQuestions_revAFE_Revised_10062021 CLEAN.docx	Form and Instruction
Form 2 Survey on Crime Prevention for Truckers TruckerCrimesQuestions_revAFE_Revised_10062021 CLEAN.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Form 2	Survey on Crime Prevention for Truckers	TruckerCrimesQuestions.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form 2	Survey on Crime Prevention for Truckers	TruckerCrimesQuestions - question 40 added CLEAN.docx	Yes	Yes	Fillable Fileable
Form and Instruction	Form 2	Survey on Crime Prevention for Truckers	TruckerCrimesQuestions_revAFE_Revised_10062021 CLEAN.docx	Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 800

Number of Respondents for Small Entity: 500

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 82 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	800	800
Annual IC Time Burden (Hours)	267	267
Annual IC Cost Burden (Dollars)	0	0

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.