Information Collection

Driver Information Form & Informed Consent Form

IC 234134 under ICR 201811-2126-002 · OMB 2126-0068.

Documents and Forms

Document Name Document Type
Form 4 Driver Information Form & Informed Consent Form Form and Instruction
4 Driver Activtiy Form Sample Driver Activity Form.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Driver Information Form & Informed Consent Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 49 CFR 381.400

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4	Driver Activtiy Form	Sample Driver Activity Form.docx		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 500	Number of Respondents for Small Entity: 0

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

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	167	167
Annual IC Cost Burden (Dollars)	4,975	4,975

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.