Information Collection

Daily Field Study Data Collection: Caffeine Log

IC 228901 under ICR 201710-2126-003 · OMB 2126-0066.

Documents and Forms

Document Name Document Type
Form Smart Phone App Daily Field Study Data Collection: Caffeine Log Form and Instruction
Smart Phone App Smart Phone App Attachment S - Sample SmartPhone Apps.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Daily Field Study Data Collection: Caffeine Log	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 49 CFR 395 49 CFR 381.400 49 CFR 1.73

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Smart Phone App	Smart Phone App	Attachment S - Sample SmartPhone Apps.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 160	Number of Respondents for Small Entity: 25

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	57,600	57,600
Annual IC Time Burden (Hours)	960	960
Annual IC Cost Burden (Dollars)	29,165	29,165

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.