Information Collection

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

IC 216160 under ICR 201502-2127-002 · 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⚠️ Notice: This information collection may be referencing outdated material.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 1271 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction
NHTSA Form 1271 NHTSA UDDP Comm Checks Moderators Guide NHTSA UDDP Comm Checks Moderators Guide_FINAL_KH.docx	Form and Instruction
NHTSA Form 1270 NHTSA UDDP Screener NHTSA UDDP Screener_FINAL_KH sm (3).docx	Form
NHTSA UDDP Fast Track Clearance Request Comm Checks_081214_KH_04162015.docx Genereic Clearance Request	IC Document
Storyboard Version for OMB Submission_KH_04162015.pdf Storyboard - Creature	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 and Instruction	NHTSA Form 1271	NHTSA UDDP Comm Checks Moderators Guide	NHTSA UDDP Comm Checks Moderators Guide_FINAL_KH.docx		No		Paper Only
Form	NHTSA Form 1270	NHTSA UDDP Screener	NHTSA UDDP Screener_FINAL_KH sm (3).docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 48

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	48	48
Annual IC Time Burden (Hours)	62	62
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Genereic Clearance Request	NHTSA UDDP Fast Track Clearance Request Comm Checks_081214_KH_04162015.docx	04/16/2015
Storyboard - Creature	Storyboard Version for OMB Submission_KH_04162015.pdf	04/16/2015

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