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⚠️ Notice: This information collection may be referencing outdated material.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 1272 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Form and Instruction
NHTSA Form 1272 Survey for Seat Belt Safety Public Service Advertising C Tween Seat Belt Safety Survey_091914_FINAL.docx Form and Instruction
Fast_Track_Clearance_Request_-_Tween Seat Belt Safety_ Online_Survey_091914.docx Fast Track Clearance Request 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	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 1272	Survey for Seat Belt Safety Public Service Advertising Campaign	Tween Seat Belt Safety Survey_091914_FINAL.docx		Yes	Yes	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 %

	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

Title	Document	Date Uploaded
Fast Track Clearance Request	Fast_Track_Clearance_Request_-_Tween Seat Belt Safety_ Online_Survey_091914.docx	09/24/2014

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