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⚠️ Notice: This information collection may be referencing outdated material.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 1293 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Form
NHTSA Form 1293 Recruitment Screener CIOT 2015 screener for OMB 2_MJ.doc Form
Moderators Guide NHTSA Form 1294 Moderators guide for OMB review_MJ.doc Form
OMB Clearance Request 2_MJ.doc OMB 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	NHTSA Form 1293	Recruitment Screener	CIOT 2015 screener for OMB 2_MJ.doc		No		Paper Only
Form	Moderators Guide	NHTSA Form 1294	Moderators guide for OMB review_MJ.doc		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120	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	120	120
Annual IC Time Burden (Hours)	163	163
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Clearance Request	OMB Clearance Request 2_MJ.doc	01/16/2015

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