Evaluation Surveys for Impaired Driving and Safety Belt Interventions

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form NHTSA 1010 Evaluation Surveys for Impaired Driving and Safety Belt Interventions	Form and Instruction	Modified	Available
2127-0646 Generic Survey Justification May 26 2010 (2).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2010-06-09	Available
Justification for the Renewal of OMB 2127 0646.doc	Supporting Statement A	Uploaded 2008-08-20	Available
Justification for the Renewal of OMB 21270646 Part B.doc	Supporting Statement B	Uploaded 2008-08-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
184552	Evaluation Surveys for Impaired Driving and Safety Belt Interventions	Form and Instruction	Modified

ICR Details

OMB Control No: 2127-0646	ICR Reference No: 201005-2127-005
Status: Historical Active	Previous ICR Reference No: 200804-2127-006
Agency/Subagency: DOT/NHTSA	Agency Tracking No:
Title: Evaluation Surveys for Impaired Driving and Safety Belt Interventions
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/17/2010
	Date Received in OIRA: 06/21/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2011	08/31/2011	08/31/2011
Responses	164,800	0	164,800
Time Burden (Hours)	27,468	0	27,468
Cost Burden (Dollars)	327,458	0	327,458

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Abstract: These are pre/post telephone surveys to evaluate safety belt mobilizations, impaired driving mobilizations, and belt/alcohol demonstration projects. National, State, and local samples will be used.

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Authorizing Statute(s): US Code: 49 USC Ch. 301, Sec. 30168 Name of Law: Motor Vehicle Safety
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 66026	11/26/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 5905	01/31/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Evaluation Surveys for Impaired Driving and Safety Belt Interventions	NHTSA 1010, NHTSA 1011, NHTSA 1103	Click It or Ticket It Surveys ,   You Drink and Drive You Loose Telephone Surveys ,   Demonstration Surveys

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	164,800	164,800	0	-8,000	8,000	0
Annual Time Burden (Hours)	27,468	27,468	0	-1,333	1,333	0
Annual Cost Burden (Dollars)	327,458	327,458	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The change in burden hours are because the agency added a demonstration survey to the generic IC.

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Annual Cost to Federal Government: $576,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/21/2010

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