Information Collection

[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool

IC 272172 under ICR 202503-0920-028 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction
Email Invitation [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction
First Follow-up Email [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction
Second Follow-up Email [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction
Semi-Structured Interview Guide [NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool	Form and Instruction
Email Invitation Att2_Email Invitations.docx	Form and Instruction
Email Invitation Att2_Email Invitations.docx	Form and Instruction
First Follow-up Email Att3_Follow up email First.docx	Form and Instruction
First Follow-up Email Att3_Follow up email First.docx	Form and Instruction
Second Follow-up Email Att4_Follow up email Second.docx	Form and Instruction
Second Follow-up Email Att4_Follow up email Second.docx	Form and Instruction
Semi-Structured Interview Guide Att1_Semi-Structured Interview Guide.docx	Form and Instruction
Semi-Structured Interview Guide Att1_Semi-Structured Interview Guide.docx	Form and Instruction
Att5_Research Determination.docx Research Determination	IC Document
Att5_Research Determination.docx Research Determination	IC Document
Att6_Privacy Act Determination.pdf Privacy Act Determination	IC Document
Att6_Privacy Act Determination.pdf Privacy Act Determination	IC Document
Transportation Safey Resource for Action_SSA_GenIC_final.docx SSA	IC Document
Transportation Safey Resource for Action_SSA_GenIC_final.docx SSA	IC Document
Transportation Safey Resource for Action_SSB_GenIC.docx SSB	IC Document
Transportation Safey Resource for Action_SSB_GenIC.docx SSB	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

[NCIPC] Formative Evaluation for Transportation Safety Resource for Action Tool

Agency IC Tracking Number:

0920-1154-25AV

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 145

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	145	145
Annual IC Time Burden (Hours)	24	24
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Research Determination		11/06/2024
Privacy Act Determination		11/06/2024
SSA		11/06/2024
SSB		11/06/2024

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

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