Information Collection

Survey Form 1805 - Modules 1 & 2

IC 269518 under ICR 202503-2127-002 · OMB 2127-0772.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1805 National Traffic Safety Survey - Modules 1 & 2 Survey Form 1805 - Modules 1 & 2	Form and Instruction
1805 National Traffic Safety Survey - Modules 1 & 2 NTSS_Form1805_Survey_Modules1&2_03-12-2025.docx	Form and Instruction

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 and Instruction	1805				Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 681

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	Previously Approved
Annual Number of Responses for this IC	681	681
Annual IC Time Burden (Hours)	341	341
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.

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