Information Collection

Alcohol-Impaired Driving Segmentation Study

IC 262878 under ICR 202309-2127-002 · OMB 2127-0766.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1710 Alcohol-Impaired Driving Segmentation Study	Form and Instruction
NHTSA - Alcohol-Impaired Driving Segmentation Study - Cognitive_FINAL.docx	Instruction
NHTSA - Alcohol-Impaired Driving Segmentation Study - Cognitive_FINAL.docx	Instruction
NHTSA Form 1710 Alcohol-Impaired Driving Segmentation Study Screener NHTSA - Alcohol-Impaired Driving Segmentation Study - SCREENER_FINAL.docx	Form and Instruction
NHTSA Form 1710 Alcohol-Impaired Driving Segmentation Study Screener NHTSA - Alcohol-Impaired Driving Segmentation Study - SCREENER_FINAL.docx	Form and Instruction
NHTSA Form 1711 Alcohol-Impaired Driving Segmentation Study Questionnair NHTSA - Alcohol-Impaired Driving Segmentation Study - Questionnaire_FINAL.docx	Form and Instruction
NHTSA Form 1711 Alcohol-Impaired Driving Segmentation Study Questionnair NHTSA - Alcohol-Impaired Driving Segmentation Study - Questionnaire_FINAL.docx	Form and Instruction
NHTSA Form 1710 Alcohol Segmentation Study Screener_FINAL 01 30 2024 NHTSA - Alcohol-Impaired Driving Segmentation Study - SCREENER_FINAL _01 30 2024.docx	Form and Instruction
NHTSA Form 1710 Alcohol-Impaired Driving Segmentation Study Cognitive Te NHTSA - Alcohol-Impaired Driving Segmentation Study - Cognitive Testing GUIDE_FINAL 01 30 2024.docx	Form and Instruction
NHTSA Form 1711 Alcohol-Impaired Driving Segmentation Study Questionnair NHTSA - Alcohol-Impaired Driving Segmentation Study - Questionnaire_FINAL _ 01 30 2024.docx	Form and Instruction
NHTSA Alcohol-Impaired Driving Segmentation Study - Supporting Statements Part A_FINAL.docx Alcohol-Impaired Driving Segmentation Study Supporting Statement Part A	IC Document
NHTSA Alcohol-Impaired Driving Segmentation Study - Supporting Statements Part A_FINAL.docx Alcohol-Impaired Driving Segmentation Study Supporting Statement Part A	IC Document
NHTSA Alcohol-Impaired Driving Segmentation Study - Supporting Statements Part B_FINAL.docx Alcohol-Impaired Driving Segmentation Study Supporting Statement Part B	IC Document
NHTSA Alcohol-Impaired Driving Segmentation Study - Supporting Statements Part B_FINAL.docx Alcohol-Impaired Driving Segmentation Study Supporting Statement Part B	IC Document
Alcohol-Impaired Driving Segmentation Study 60-Day Notice Post.pdf Alcohol-Impaired Driving Segmentation Study Federal Register 60-Day Notice	IC Document
Alcohol-Impaired Driving Segmentation Study 60-Day Notice Post.pdf Alcohol-Impaired Driving Segmentation Study Federal Register 60-Day Notice	IC Document
NHTSA-2022-0077-0002_attachment_1.pdf Alcohol-Impaired Driving Segmentation Study 60-Day Public Comment 1	IC Document
NHTSA-2022-0077-0002_attachment_1.pdf Alcohol-Impaired Driving Segmentation Study 60-Day Public Comment 1	IC Document
NHTSA-2022-0077-0003_attachment_1.pdf Alcohol-Impaired Driving Segmentation Study 60-Day Public Comment 2	IC Document
NHTSA-2022-0077-0003_attachment_1.pdf Alcohol-Impaired Driving Segmentation Study 60-Day Public Comment 2	IC Document
Part A - NHTSA Alcohol Impaired Driving Segmentation Study _ FINAL 01 30 2024.docx PART A - NHTSA Alcohol-Impaired Driving Segmentation Study FINAL 01 03 2024	IC Document
Part B - NHTSA Alcohol Impaired Driving Segmentation Study _ FINAL 01 30 2024.docx Part B - NHTSA Alcohol-Impaired Driving Segmentation Study FINAL 01 30 2024	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Alcohol-Impaired Driving Segmentation Study

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	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 1710	Alcohol-Impaired Driving Segmentation Study Screener	NHTSA - Alcohol-Impaired Driving Segmentation Study - SCREENER_FINAL.docx	Yes	Yes	Printable Only
Instruction			NHTSA - Alcohol-Impaired Driving Segmentation Study - Cognitive_FINAL.docx	Yes	Yes	Printable Only
Form and Instruction	NHTSA Form 1711	Alcohol-Impaired Driving Segmentation Study Questionnaire	NHTSA - Alcohol-Impaired Driving Segmentation Study - Questionnaire_FINAL.docx	Yes	Yes	Printable Only
Form and Instruction	NHTSA Form 1710	Alcohol Segmentation Study Screener_FINAL 01 30 2024	NHTSA - Alcohol-Impaired Driving Segmentation Study - SCREENER_FINAL _01 30 2024.docx	Yes	Yes	Printable Only
Form and Instruction	NHTSA Form 1710	Alcohol-Impaired Driving Segmentation Study Cognitive Testing Guide_FINAL 01 30 2024	NHTSA - Alcohol-Impaired Driving Segmentation Study - Cognitive Testing GUIDE_FINAL 01 30 2024.docx	Yes	Yes	Printable Only
Form and Instruction	NHTSA Form 1711	Alcohol-Impaired Driving Segmentation Study Questionnaire FINAL 01 30 2024	NHTSA - Alcohol-Impaired Driving Segmentation Study - Questionnaire_FINAL _ 01 30 2024.docx	Yes	Yes	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,400	5,400
Annual IC Time Burden (Hours)	3,845	3,845
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Alcohol-Impaired Driving Segmentation Study Supporting Statement Part A	NHTSA Alcohol-Impaired Driving Segmentation Study - Supporting Statements Part A_FINAL.docx	10/19/2023
Alcohol-Impaired Driving Segmentation Study Supporting Statement Part B	NHTSA Alcohol-Impaired Driving Segmentation Study - Supporting Statements Part B_FINAL.docx	10/19/2023
Alcohol-Impaired Driving Segmentation Study Federal Register 60-Day Notice	Alcohol-Impaired Driving Segmentation Study 60-Day Notice Post.pdf	10/19/2023
Alcohol-Impaired Driving Segmentation Study 60-Day Public Comment 1	NHTSA-2022-0077-0002_attachment_1.pdf	10/19/2023
Alcohol-Impaired Driving Segmentation Study 60-Day Public Comment 2	NHTSA-2022-0077-0003_attachment_1.pdf	10/19/2023
PART A - NHTSA Alcohol-Impaired Driving Segmentation Study FINAL 01 03 2024	Part A - NHTSA Alcohol Impaired Driving Segmentation Study _ FINAL 01 30 2024.docx	01/30/2024
Part B - NHTSA Alcohol-Impaired Driving Segmentation Study FINAL 01 30 2024	Part B - NHTSA Alcohol Impaired Driving Segmentation Study _ FINAL 01 30 2024.docx	01/30/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.