Information Collection

Informed Consent Form

IC 274982 under ICR 202504-2127-007 · OMB unassigned.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 2009 Informed Consent Form	Form and Instruction
Form NHTSA Form 2009 Participant Informed Consent Form Informed Consent Form	Form and Instruction
NHTSA Form 2009 Participant Informed Consent Form 4_NHTSA Form 2009_Participant Informed Consent Form for Driving Study with Video Data_Clean.docx	Form and Instruction
NHTSA Form 2009 Participant Informed Consent Form 4_NHTSA Form 2009_Participant Informed Consent Form for Driving Study with Video Data_Clean.docx	Form and Instruction

IC Title:

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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 2009				Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 67

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	67	67
Annual IC Time Burden (Hours)	39	39
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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