Information Collection

Recruit/Screener

IC 255963 under ICR 202209-2127-003 · OMB 2127-0762.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1681 Recruit/Screener	Form
NHTSA Form 1681 NCAP 5-Star Label Consumer Research - SCREENER Appendix D - Form 1681 NCAP 5-Star Label Consumer Research - SCREENER - 8-25-2022.docx	Form
NHTSA Form 1681 NCAP 5-Star Label Consumer Research - SCREENER Appendix D - Form 1681 NCAP 5-Star Label Consumer Research - SCREENER - 8-25-2022.docx	Form

IC Title:

Recruit/Screener

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	NHTSA Form 1681	NCAP 5-Star Label Consumer Research - SCREENER	Appendix D - Form 1681 NCAP 5-Star Label Consumer Research - SCREENER - 8-25-2022.docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	42	42
Annual IC Cost Burden (Dollars)	1,257	1,257

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.