View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Computerized Neurocognitive Tests for Aeromedical Safety	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation: 14 CFR 44507

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	2	Demographics	Questionnaire Part 2 - Demographics.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	3	Current State and Sleepiness	Questionnaire Part 3 - CSS_and_SSS.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	4	Relevancy	Questionnaire Part 4 - Relevancy.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	5	Final Survey Set	Questionnaire Part 5 - Final Survey Set.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	1	Informed Consent (with Burden Statement)	Questionnaire Part 1 - Burden Statement and Informed Consent.pdf		Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Transportation

Subfunction: Air Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	1,000	0	1,000	0	0	0
Annual IC Time Burden (Hours)	4,000	0	4,000	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	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.