Information Collection

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

IC 220502 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⚠️ Notice: This information collection may be referencing outdated material.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 1341 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form
NHTSA Form 1341 Recruitment Screener Move Over Screener_revised 02 29 16_FINAL.docx	Form
NHTSA Form 1342 Moderator's Guide Move Over mod guide 021616 FINAL.doc	Form
Move Over Generic Clearance_revised 02 29 16.doc Generic Clearance Request	IC Document
Move Over Layouts.pdf Move Over Layouts	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 1341	Recruitment Screener	Move Over Screener_revised 02 29 16_FINAL.docx		No		Fillable Fileable
Form	NHTSA Form 1342	Moderator's Guide	Move Over mod guide 021616 FINAL.doc		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 96

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	96	96
Annual IC Time Burden (Hours)	124	124
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Clearance Request	Move Over Generic Clearance_revised 02 29 16.doc	03/08/2016
Move Over Layouts	Move Over Layouts.pdf	03/08/2016

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