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⚠️ Notice: This information collection may be referencing outdated material.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 1335 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Form
NHTSA Form 1335 Buzzed Driving Screener BUZZED DRIVING SCREENING REVISED_020316_FINAL.docx Form
NHTSA Form 1336 Buzzed Driving Moderators Guide BUZZED DRIVING MODERATORS GUIDE_020316_FINAL.docx Form and Instruction
NHTSA Buzzed Fast Track Clearance Request_021216.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	NHTSA Form 1335	Buzzed Driving Screener	BUZZED DRIVING SCREENING REVISED_020316_FINAL.docx		Yes	Yes	Fillable Fileable
Form and Instruction	NHTSA Form 1336	Buzzed Driving Moderators Guide	BUZZED DRIVING MODERATORS GUIDE_020316_FINAL.docx		No		Paper Only

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: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	72	72
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	NHTSA Buzzed Fast Track Clearance Request_021216.docx	02/16/2016

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