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Impaired Driving Survey
Evaluation of Community-Oriented Enforcement Demonstrations
OMB: 2127-0725
IC ID: 222278
OMB.report
DOT/NHTSA
OMB 2127-0725
ICR 201704-2127-002
IC 222278
( )
Documents and Forms
Document Name
Document Type
Form 1322
Impaired Driving Survey
Form and Instruction
1322 Impaired Driving Survey
Appendix B Impaired Driving Survey Form 1322 04052017.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Impaired Driving Survey
Agency IC Tracking Number:
1322
Is this a Common Form?
No
IC Status:
Modified
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 and Instruction
1322
Impaired Driving Survey
Appendix B Impaired Driving Survey Form 1322 04052017.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,400
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2,400
0
2,400
0
0
0
Annual IC Time Burden (Hours)
400
0
400
0
0
0
Annual IC Cost Burden (Dollars)
9,288
0
9,288
0
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.