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⚠️ Notice: This information collection may be referencing outdated material.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 1253 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Form
NHTSA Form 1253 NHTSA Tween Seat Belt Comm Checks Moderators Guide - Eng NHTSA Tween Seat Belt Comm Checks Moderators Guide_Final.docx Form
NHTSA Form 1254 NHTSA Tween Seat Belt Comm Checks Moderators Guide - Spa NHTSA Tween Seat Belt Comm Checks Spanish Moderators Guide_Final 0313201 (2).docx Form
NHTSA Form 1255 NHTSA Tween Seat Belt Recruitment Screener - English NHTSA Tween Seat Belt Recruitment Screener_Final 03132014.docx Form
NHTSA Form 1256 NHTSA Tween Seat Belt Recruitment Screener - Spanish NHTSA Tween Seat Belt Spanish Recruitment Screener_Final 03132014.docx Form
Fast Track Clearance Request_Tween Seat Belt Safety Comm Checks.docx Fast Track Clearance Request_Tween Seat Belt Safety IC Document
Storyboards English - Extremes.pdf Storyboards English - Extremes IC Document
Storyboards English - Never Quit.pdf Storyboards English - Never Quit IC Document
Storyboards Spanish - Extremes.pdf Storyboards Spanish - Extremes IC Document
Storyboards Spanish - Never Quit.pdf Storyboards Spanish - Never Quit IC Document

Information Collection (IC) Details

View Information Collection (IC)

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:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	NHTSA Form 1253	NHTSA Tween Seat Belt Comm Checks Moderators Guide - English	NHTSA Tween Seat Belt Comm Checks Moderators Guide_Final.docx	No	Paper Only
Form	NHTSA Form 1254	NHTSA Tween Seat Belt Comm Checks Moderators Guide - Spanish	NHTSA Tween Seat Belt Comm Checks Spanish Moderators Guide_Final 0313201 (2).docx	No	Paper Only
Form	NHTSA Form 1255	NHTSA Tween Seat Belt Recruitment Screener - English	NHTSA Tween Seat Belt Recruitment Screener_Final 03132014.docx	No	Fillable Fileable
Form	NHTSA Form 1256	NHTSA Tween Seat Belt Recruitment Screener - Spanish	NHTSA Tween Seat Belt Spanish Recruitment Screener_Final 03132014.docx	No	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 72	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	126	126
Annual IC Time Burden (Hours)	93	93
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Fast Track Clearance Request_Tween Seat Belt Safety	Fast Track Clearance Request_Tween Seat Belt Safety Comm Checks.docx	04/21/2014
Storyboards English - Extremes	Storyboards English - Extremes.pdf	04/21/2014
Storyboards English - Never Quit	Storyboards English - Never Quit.pdf	04/21/2014
Storyboards Spanish - Extremes	Storyboards Spanish - Extremes.pdf	04/21/2014
Storyboards Spanish - Never Quit	Storyboards Spanish - Never Quit.pdf	04/21/2014

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