Information Collection

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

IC 214664 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⚠️ Notice: This information collection may be referencing outdated material.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 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

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 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 %

table that charts list of burden
	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

table that charts IC Documents
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.