Information Collection

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

IC 205082 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⚠️ Notice: This information collection may be referencing outdated material.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 1182 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form
NHTSA Form 1182 Impaired Driving Survey Impaired Driving Online Survey Questionnaire_111512 doc (3).doc	Form
Fast Track Clearance Request_Impaired Driving_ OnlineSurvey_111512 docx.docx Fast Track Clearance Request Impaired Driving Survey	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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NHTSA Form 1182	Impaired Driving Survey	Impaired Driving Online Survey Questionnaire_111512 doc (3).doc		No		Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,900

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	3,900	3,900
Annual IC Time Burden (Hours)	215	215
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Clearance Request Impaired Driving Survey	Fast Track Clearance Request_Impaired Driving_ OnlineSurvey_111512 docx.docx	12/11/2012

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