Information Collection

Pre-study Demographics & Previous Experiences questionnaire

IC 258311 under ICR 202302-2126-002 · OMB 2126-0080.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2126-0080 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Pre-Study Demograp Pre-study Demographics & Previous Experiences questionnaire	Form
Pre-Study Demograp Attachment I - Pre-study Demographics Attachment I - Pre-study demographics.docx	Form
Pre-Study Demograp Attachment I - Pre-study Demographics Attachment I - Pre-study demographics.docx	Form

IC Title:

Pre-study Demographics & Previous Experiences questionnaire

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 49 CFR 1.87

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	Pre-Study Demographics & Experience Questionnaire	Attachment I - Pre-study Demographics	Attachment I - Pre-study demographics.docx		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 110

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	110	110
Annual IC Time Burden (Hours)	8	8
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.