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IC2: Apprentice Driver Information Form & Informed Consent Form
Safe Driver Apprenticeship Pilot Program
OMB: 2126-0075
IC ID: 250988
OMB.report
DOT/FMCSA
OMB 2126-0075
ICR 202112-2126-004
IC 250988
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2126-0075 can be found here:
2024-09-20 - Extension without change of a currently approved collection
2024-04-01 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form Form 2
IC2: Apprentice Driver Information Form & Informed Consent Form
Form and Instruction
Form 2 Apprentice Driver Application
Attachment H_SafeDriverAPP_Apprentice Driver_Application.docx
Form and Instruction
Form 2 Apprentice Driver Application
Attachment H_SafeDriverAPP_Apprentice Driver_Application.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
IC2: Apprentice Driver Information Form & Informed Consent Form
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Required to Obtain or Retain Benefits
CFR Citation:
29 CFR 29
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
Form 2
Apprentice Driver Application
Attachment H_SafeDriverAPP_Apprentice Driver_Application.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
11,067
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
11,067
11,067
0
0
0
0
Annual IC Time Burden (Hours)
3,689
3,689
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
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.