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⚠️ Notice: This information collection may be referencing outdated material.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 1356 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Form and Instruction
NHTSA Form 1356 Drugged Driving Moderators Guide Drugged Driving mod guide 050316_FINAL.doc Form and Instruction
NHTSA Form 1355 Drugged Driver Screener Drugged Driving Screener 050316_FINAL.docx Form and Instruction
Drugged Driving Generic Clearance 042616_FINAL.docx Drugged Driving Generic Clearance IC Document
Stoned Face.jpg Stoned Face IC Document
Not Moving.jpg Not Moving IC Document
Joint and Wheel.jpg Joint and Wheel IC Document
Fuzzy Dash.jpg Fuzzy Dash 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 and Instruction	NHTSA Form 1356	Drugged Driving Moderators Guide	Drugged Driving mod guide 050316_FINAL.doc		No		Paper Only
Form and Instruction	NHTSA Form 1355	Drugged Driver Screener	Drugged Driving Screener 050316_FINAL.docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 180	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	180	180
Annual IC Time Burden (Hours)	198	198
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Drugged Driving Generic Clearance	Drugged Driving Generic Clearance 042616_FINAL.docx	05/12/2016
Stoned Face	Stoned Face.jpg	05/12/2016
Not Moving	Not Moving.jpg	05/12/2016
Joint and Wheel	Joint and Wheel.jpg	05/12/2016
Fuzzy Dash	Fuzzy Dash.jpg	05/12/2016

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