Driving Survey -Screenshot

Quantification of Behavioral and Physiological Effects of Drugs Using a Mobile Scalable Device

Documents and Forms

Document Name Document Type
Form 8 Driving Survey -Screenshot Form
8 Driving Survey Screenshot Attachment 7 Screenshot of MSD-Driving Survey.pdf Form

Information Collection (IC) Details

IC Title:	Driving Survey -Screenshot	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	8	Driving Survey Screenshot	Attachment 7 Screenshot of MSD-Driving Survey.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: SORN	FR Citation: 67 FR 60741

Number of Respondents: 72	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	18	18
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.