Evaluation Surveys for Impaired Driving and Safety Belt Interventions

Forms and Documents

Document Name	Status
Form NHTSA Form 1010 Evaluation Surveys for Impaired Driving and Safety Belt Interventions Form	New
Section A 2127_0646 renewal (2).doc Supporting Statement A	2011-04-12
Section B 2127_0646 renewal.doc Supporting Statement B	2011-04-12

IC Document Collections

IC ID	Document Title	Status
197260	Evaluation Surveys for Impaired Driving and Safety Belt Interventions Form	New

ICR Details

OMB Control No: 2127-0646	ICR Reference No: 201104-2127-003
Status: Historical Active	Previous ICR Reference No: 201005-2127-005
Agency/Subagency: DOT/NHTSA	Agency Tracking No:
Title: Evaluation Surveys for Impaired Driving and Safety Belt Interventions
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/08/2011
	Date Received in OIRA: 05/02/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2014	36 Months From Approved	08/31/2011
Responses	200,000	0	164,800
Time Burden (Hours)	27,468	0	27,468
Cost Burden (Dollars)	214,200	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:
	75 FR 76781	12/09/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 12791	03/08/2011
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Evaluation Surveys for Impaired Driving and Safety Belt Interventions	NHTSA Form 1010, NHTSA Form 1011, NHTSA Form 1010A, NHTSA Form 1011A	Click it or Ticket Mobilization ,   Clickk it or Ticket Mobilization Screener ,   Alcohol Crackdown Questionnaire ,   Alcohol Crackdown Screener

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ICR Summary 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	200,000	164,800	0	0	35,200	0
Annual Time Burden (Hours)	27,468	27,468	0	10,668	-10,668	0
Annual Cost Burden (Dollars)	214,200	327,458	0	214,200	-327,458	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: NHTSA has determined that the currently approved inventory exceeds the number of interviews that the agency expects to request over the next three years for information collections that would fall under clearance 2127-0646. The agency is therefore requesting a revision that would decrease the approved inventory by 4,589 interviews, as a result the burden hours are reduced to 26,702. The reduced inventory will still be of sufficient size to give NHTSA the flexibility to meet its information collection needs.

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Annual Cost to Federal Government: $1,331,000

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]? No

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: 05/02/2011

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