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Study
Emergency Medical Services (EMS) Sleep Health and Fatigue Education
OMB: 2127-0742
IC ID: 233940
OMB.report
DOT/NHTSA
OMB 2127-0742
ICR 201811-2127-003
IC 233940
( )
Documents and Forms
Document Name
Document Type
Form 1463
Study
Form and Instruction
1463 Baseline Survey
Form1463-BaselineSurvey.pdf
Form and Instruction
1465 Follow-up Survey
Form1465-FollowUpSurvey.pdf
Form and Instruction
1464 Text Message Queries
Form1464-TextMessageQueriesScreenshots.pdf
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Study
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 and Instruction
1463
Baseline Survey
Form1463-BaselineSurvey.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
1465
Follow-up Survey
Form1465-FollowUpSurvey.pdf
Yes
Yes
Fillable Fileable
Form and Instruction
1464
Text Message Queries
Form1464-TextMessageQueriesScreenshots.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,200
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
1,200
0
1,200
0
0
0
Annual IC Time Burden (Hours)
9,500
0
9,500
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
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.