PRA IC List
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Agenda
Reg Review
ICR
Information Collection List
IC Title
Status
Responses
Hours
Dollars
Document Type
Form No.
Form Name
Task 1 - Recruitment
New
160
27
0
Form and Instruction
Form No. 1
Recruitment Materials
Task 2 - Consent Form
New
88
22
0
Form and Instruction
Form No. 2
Consent Form
Task 3 - W-9 Form
New
88
4
0
Form and Instruction
Form No. 3
W9 Form
Task 4 - Pre-study Demographics & Previous Experiences questionnaire
New
88
7
0
Form and Instruction
Form No. 4
Questionnaire #1 – Pre-Study Demographic/Previous Experiences
Task 5 - Perceptions of Technology & Vehicle ADS questionnaire
New
88
9
0
Form and Instruction
Form No. 5
Questionnaire #2 – Perceptions of Technology and Vehicle Safety Technologies
Task 6 - PVT
New
704
35
0
Form and Instruction
Form No. 6
Questionnaire #3 - PVT
Task 7 - Pre-Study Driver Behavior questionnaire
New
88
5
0
Form and Instruction
Form No. 7
Questionnaire #4 - Simulator Sickness Questionnaire
Task 8 - Post-Study ADS Experiences & Perceptions questionnaire
New
88
9
0
Form and Instruction
Form No. 8
Questionnaire #5 – Post Study Experiences/Perceptions
Task 9 - Human-ADS Team Driving
New
88
1408
0
Total burden requested under this ICR:
1480
1526
0
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