Information Collection

Older Driver Rearview Video Systems

IC 259483 under ICR 202303-2127-002 · OMB 2127-0731.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1399 Older Driver Rearview Video Systems	Form and Instruction
NHTSA Form 1399 Consent Form and Instructions NCC200_RVS Training for Older Drivers ICR Form 1399.pdf	Form and Instruction
NHTSA Form 1399 Consent Form and Instructions NCC200_RVS Training for Older Drivers ICR Form 1399.pdf	Form and Instruction
NHTSA Form 1398 Screener NCC200_RVS Training for Older Drivers ICR Form 1398.docx	Form
NHTSA Form 1398 Screener NCC200_RVS Training for Older Drivers ICR Form 1398.docx	Form

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 23 CFR 403(b)(1)(A)(i)-(ii), (1)(B) (To search for a specific CFR, visit the Code of Federal Regulations.)

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 and Instruction	NHTSA Form 1399	Consent Form and Instructions	NCC200_RVS Training for Older Drivers ICR Form 1399.pdf		No		Paper Only
Form	NHTSA Form 1398	Screener	NCC200_RVS Training for Older Drivers ICR Form 1398.docx		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 120

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	120	120
Annual IC Time Burden (Hours)	210	210
Annual IC Cost Burden (Dollars)	6,124	6,124

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.