Form 1827 In-Vehicle Pre-Drive Questionnaire

NHTSA Form #1827 OMB Control #X Expiration #X

Vehicle Occupant Anthropometry, Posture, and Motion Participant Number_________

Paperwork Reduction Act Statement

A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-XXXX. The information collected in this study will be used to create a database of vehicle occupant body size, shape, and posture. The data will be used to improve vehicle safety. We estimate that it will take approximately 5 minutes to complete this form. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Room W45-205, Washington, DC, 20590.

Pre-Drive Questionnaire

[Completed in the Research Vehicle after adjusting the seat and other components]

Compare this vehicle to the vehicle you drive most (“my vehicle”):

(circle a number)

Compared to my vehicle, the seat is (circle one):

Too Low Just Right Too High

1 2 3 4 5

Compared to my vehicle, the seat is (circle one):

Too Far Rearward Just Right Too Far Forward

1 2 3 4 5

Compared to my vehicle, the steering wheel is:

Too Low Just Right Too High

1 2 3 4 5

Compared to my vehicle, the steering wheel is:

Too Far Rearward Just Right Too Far Forward

1 2 3 4 5

Compared to my vehicle, the brake pedal is:

Too Far Rearward Just Right Too Far Forward

1 2 3 4 5

Do you have any other comments on the vehicle layout?