Eligibility Questionnaire

FMVSS Considerations for Vehicles with Automated Driving Systems: Seating Preference Study

Documents and Forms

Document Name Document Type
Form NHTSA Form 1624 Eligibility Questionnaire Form
NHTSA Form 1624 Eligibility Questionnaire Seat Preference Study Draft Eligibility Questionnaire_2022-02-23 clean.docx Form

Information Collection (IC) Details

IC Title:	Eligibility Questionnaire	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	NHTSA Form 1624	Eligibility Questionnaire	Seat Preference Study Draft Eligibility Questionnaire_2022-02-23 clean.docx		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	67	67
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.