OMB NO: 2126-XXXX
EXPIRATION DATE: mm/dd/yyyy
MCSA-5849
Public Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2126-XXXX. Public reporting for this collection of information is estimated to be approximately 15 minutes per response, including the time for reviewing instructions, gathering the data needed, and completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Federal Motor Carrier Safety Administration, MC-RRA, 1200 New Jersey Avenue, SE, Washington, D.C. 20590.
Annual Commercial Vehicle Driver Survey:
Work and Compensation
Background
This survey is intended to collect information about your work history, compensation, and work schedule as a commercial motor vehicle driver. You will be given $10.00 for your participation.
Interviewers will collect the following information:
Date: ____________ Time: ___________
Location: _________________________________
Is the driver male or female? Male Female
The following questions will be used to determine if you are eligible for the survey:
Do you have a CDL? Yes No
Are you willing to participate? Yes No Language Barrier
Work History
How many years have you been driving a commercial vehicle? __________
What year did you obtain your first CDL? _________ Check if “grandfathered in”
Current license class? A B C Other (please specify) ___________
What endorsements do you have?
Passenger Yes No
Double-Triple Trailer Yes No
Tank Vehicle Yes No
Hazmat Yes No
School Bus Yes No
Intrastate (Restriction) Yes No
None Yes No
Other. Please specify: __________________
What type of operation are you currently involved in?
For-hire: your employer transports freight for another company
Private: your employer transports their own freight or carries only non-paying passengers
For example, a private company might be a chain of grocery stores that transports goods from their warehouse to their stores.
Are you currently: (Check one.)
employed as a full or part-time employee of a motor carrier
an owner-operator normally leased only to one motor carrier, or
an owner-operator leased to several motor carriers?
None of the above. Please explain. _________________________________________
Which category best describes the shipments handled by you/your company?
Truckload (Shipments greater than 10,000 lbs. that do not require a terminal or break- bulk operation)
Less-than-truckload (Terminal or break-bulk operation required)
Package (Shipments of packages under 100 lbs. that require a terminal or break-bulk operation)
Bus/Passengers
Primarily Hazardous Material Cargo
Other: Please specify:___________________________________________________
What is the average length (in miles) of your average haul (NOTE: NOT total shift travel; simply from terminal pickup to first drop off)? _______
How many nights of the week are you on the road working away from home? _______
Do you drive in more than one state?
Yes No
What best describes your trips?
Long haul (motor carrier operations with an average length of haul greater than 400 miles)
Regional (motor carrier operations with an average length of haul between 150–400 miles)
Short haul (Motor carrier operations conducted solely within a 150 air-mile radius from their terminals and require drivers to return to their work-reporting location every night)
What type of truck or passenger-vehicle do you most frequently drive? (Check one.)
Truck with Gross Vehicle Weight Rating (GVWR) 26,000 lbs or less
Straight truck with GVWR over 26,000 lbs. (e.g., a truck with the cargo body and tractor mounted on the same chassis)
Articulated truck with GVWR over 26,000 lbs. (e.g., a truck with a tractor and a trailer)
Commercial vehicle designed or used to transport 9-15 paying passengers
Commercial vehicle designed or used to transport 16 or more passengers
How did you learn to drive commercial trucks?
Family/friend Yes No
Vocational technical school program Yes No
CDL focused school program Yes No
Company provided program Yes No
Farm Yes No
Military Yes No
Other: Please describe: _____________________________
If you learned to drive in a driver’s training program, who paid for the training program?
Not Applicable
Self/Family Member
Carrier/company paid or provided
Military/Government
Other: Please specify:_________________
Approximately how much did the training program cost you or your employer?
Less than $1,000 $1,001 - $3,000 $3,001 - $5,000 More than $5,000
I don’t know Not Applicable
[If necessary…Ask again…Did you say you are an owner operator or not?]
If you are not an owner-operator leased to several motor carriers, answer Q16-Q18b; otherwise, skip to Q19.
How many years have you worked for your current employer? _______________
How many trucks (owned and leased) are in the fleet of the company you work for (all types of trucks)?
1 - 10 11 - 50 51 - 100 101 – 500 More than 500
How many motor carriers have you worked for:
In the past year?
1 2 3 4 more than 5
In the past 2 years?
1 2 3 4 more than 5
In the past 3 years?
1 2 3 4 more than 5
Do you belong to belong to a union for commercial vehicle/truck drivers?
Yes No
19a. Is the company that you drive for unionized?
Yes No
19b. Are you working for this company as a unionized driver?
Yes No
Driver Compensation
How are you usually paid? (Check one.)
Salary By hour By mile By load
What is your approximate (gross) annual income just from driving?
Less than $10,000 $10,001 - $20,000 $20,001 - $30,000
$30,001 - $40,000 $40,001 - $50,000 $50,001 - $60,000
$60,001 - $70,000 $70,001 - $80,000 More than $80,000
What expenses do you have to pay for your driving job?
Truck note Yes No
Fuel Yes No
Truck repairs Yes No
Meals Yes No
Overnight Stays Yes No
Loading or Unloading Yes No
Tolls Yes No
Insurance (load) Yes No
Insurance (truck) Yes No
None Yes No
Other:____________________________________
Do you have a second paying job at any time of year (not for a motor carrier)?
Yes No (go to Q. 27)
If yes:
How many hours per week do you work at your second job?
1-10 hours a week 11-20 hours a week
21-30 hours a week 31-40 hours a week
Over 40 hours a week
How many weeks per year do you work your second job? ____________
What is your approximate annual gross income from your second paying job (not driving commercial vehicle)?
Less than $10,000 $10,001 - $20,000 $20,001 - $30,000
$30,001 - $40,000 $40,001 - $50,000 $50,001 - $60,000
$60,001 - $70,000 $70,001 - $80,000 More than $80,000
Work Schedule
Full-time Part-time Seasonal/Temporary
How many hours do you spend working (driving time+loading+maintenance+etc.)
for motor carriers during a typical seven day period? __________
How many hours do you spend just driving a commercial vehicle in a typical seven day period? _________
How many weeks did you not work in the past year? ____________
Do you drive a regular schedule (similar hours or trips, day-to-day or week-to-week)? Yes No
About what time do you typically start driving?
6AM-12PM 12PM-6PM 6PM-12AM 12AM-6AM Can’t say
At what time do you typically stop driving?
6AM-12PM 12PM-6PM 6PM-12AM 12AM-6AM Can’t say
Approximately how many total miles did you drive a commercial vehicle in the past year?
Less than 25,000 25,001 – 50,000 50,001 – 75,000 75,001 – 100,000
100,001 – 125,000 125,000 – 150,000 Over 150,000 I don’t know
Does your employer track your truck’s location electronically?
Yes No
How do you record your hours of service? (Check all that apply.)
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Yes |
No |
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Yes |
No |
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Yes |
No |
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Yes |
No |
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Yes |
No |
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How many times a day is your truck loaded and unloaded?
Loaded <1 1 2 3 4 5 6 7 8 9 10 10+
Unloaded <1 1 2 3 4 5 6 7 8 9 10 10+
What is the typical amount of time you have to wait to load?
Less than 15 min Less than 30 min Less than 1 hour 1 up to 2 hours 2 up to 4 hours 4 up to 6 hours 6 hours or more, but less than one day
More than 1 day
What is the typical amount of time you have to wait to unload?
Less than 15 min Less than 30 min Less than 1 hour 1 up to 2 hours 2 up to 4 hours 4 up to 6 hours 6 hours or more, but less than one day
More than 1 day
Are you responsible for loading or unloading your truck?
Yes No
Are you paid for loading or unloading your truck?
Loading Yes No Not Applicable
Unloading Yes No Not Applicable
How often are you in a situation where you have to break the hours of service rules?
Weekly Monthly Every Couple Months Couple Times per Year
Never
In the past 3 years, have you been involved in any commercial motor vehicle crash where there was property damage/injury or fatality?
Yes No
How many crashes have you been involved in the past 3 years?
0 1 2 3 4 5+
Always Nearly always Sometimes Seldom Never
When was the last time you did not wear your safety belt when driving your commercial motor vehicle?
I always wear it
Within the past day
Within the past week
Within the past month
Within the past year
A year or more ago
Please indicate whether you agree or disagree with the following reasons for not using your safety belt.
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Strongly Agree |
Agree |
Undecided |
Disagree |
Strongly Disagree |
Too much trouble and effort |
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Belt does not fit well |
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Restricts movement in vehicle |
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Worried about being trapped in vehicle |
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Frequently getting in and out of cab |
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Other (Specify) |
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What is your age? _______________________
(If unwilling to answer, use ranges)
Under 25 25-34 35-44 45-54 55-64
65- 74 75 or more
Do you have access to the internet?
Yes No (Complete the interview)
If yes, approximately how much time do you spend using the internet each day?
Less then 30 minutes 30 minutes to 1 hour more than 1 hour
Where do you access the internet?
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Yes |
No |
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Yes |
No |
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Yes |
No |
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Yes |
No |
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Yes |
No |
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Thank you for completing this survey.
File Type | application/msword |
Author | Mercyle.farrell |
Last Modified By | herman.dogan |
File Modified | 2010-06-25 |
File Created | 2010-06-25 |