Eligibility/Demographic Interview

Driver Alcohol Detection System for Safety Field Operational Test (DADSS-FOT)

Documents and Forms

Document Name Document Type
Form NHTSA 1647 Eligibility/Demographic Interview Form
NHTSA 1647 Eligibility Demographic Questionnaire Eligibility Demographic Questionnaire.pdf Form

Information Collection (IC) Details

IC Title:	Eligibility/Demographic Interview	Agency IC Tracking Number:

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	NHTSA 1647	Eligibility Demographic Questionnaire	Eligibility Demographic Questionnaire.pdf		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,393	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,393	1,393
Annual IC Time Burden (Hours)	697	697
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.