Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0682 can be found here:

Documents and Forms

Document Name Document Type
Form NHTSA Form 1164 Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Form
NHTSA Form 1164 CIOT Screener CIOT 2012 screener for OMB review FINAL - 2-27-12.docx Form
NHTSA Form 1165 CIOT 2012 Moderators Guide CIOT_2012_moderators_guide_for_OMB_review_rev_WC.doc Form
Dinged_Final.pdf CIOT 2012 - Dinged Storyboard IC Document
Fakearooney.pdf CIOT 2012 - Fakerooney Storyboard IC Document
Bobbleheads.pdf CIOT 2012 - Bobbleheads Storyboard IC Document
It's_Beginning.pdf CIOT 2012 - Its Beginning Storyboard IC Document
OMB_Clearance_Request_FINAL_-_2-15-12[1].docx CIOT Fast Track Justification IC Document

Information Collection (IC) Details

IC Title:	Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NHTSA Form 1164	CIOT Screener	CIOT 2012 screener for OMB review FINAL - 2-27-12.docx		No		Paper Only
Form	NHTSA Form 1165	CIOT 2012 Moderators Guide	CIOT_2012_moderators_guide_for_OMB_review_rev_WC.doc		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 96	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	96	96
Annual IC Time Burden (Hours)	106	106
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
CIOT 2012 - Dinged Storyboard	Dinged_Final.pdf	02/27/2012
CIOT 2012 - Fakerooney Storyboard	Fakearooney.pdf	02/27/2012
CIOT 2012 - Bobbleheads Storyboard	Bobbleheads.pdf	02/27/2012
CIOT 2012 - Its Beginning Storyboard	It's_Beginning.pdf	02/27/2012
CIOT Fast Track Justification	OMB_Clearance_Request_FINAL_-_2-15-12[1].docx	02/27/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.