Information Collection

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

IC 204536 under ICR 201202-2127-006 · OMB 2127-0682.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1178 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction
NHTSA Form 1178 NHTSA.gov Usability Study NHTSA gov Usability Guide 10-15-12.docx	Form and Instruction
NHTSA Form 1179 Safercar.gov Usability Study SaferCar gov Usability Guide 10-15-12.docx	Form and Instruction
NHTSA Form 1180 Usability Screener Usability Screener - 10-15-12.docx	Form
NHTSA gov Usability Study_Fast Track Generic Clearance Submission.doc Usability Study for NHTSA.gov Program	IC Document
SaferCar gov Usability Study_Fast Track Generic Clearance Submission.doc Usability Study for Safercar.gov Program	IC Document

IC 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:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 1178	NHTSA.gov Usability Study	NHTSA gov Usability Guide 10-15-12.docx	No	Paper Only
Form and Instruction	NHTSA Form 1179	Safercar.gov Usability Study	SaferCar gov Usability Guide 10-15-12.docx	No	Paper Only
Form	NHTSA Form 1180	Usability Screener	Usability Screener - 10-15-12.docx	No	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 36

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	36	36
Annual IC Time Burden (Hours)	26	26
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Usability Study for NHTSA.gov Program	NHTSA gov Usability Study_Fast Track Generic Clearance Submission.doc	10/18/2012
Usability Study for Safercar.gov Program	SaferCar gov Usability Study_Fast Track Generic Clearance Submission.doc	10/18/2012

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