Information Collection

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

IC 223349 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form NHTSA Form 1335 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Form
NHTSA Form 1335 Buzz Driving Screener BUZZED DRIVING SCREENING REVISED_070616.docx Form
NHTSA Form 1336 Moderators Guide NHTSA Comm Checks Moderators Guide_070616 (003).docx Form
NHTSA Buzzed Comm Checks Fast Track Clearance Request_071116.docx Generic Clearance Request IC Document
Buzzed Cog NHTSA 09.01.16 [CT edit].pdf Buzzed Cog NHTSA 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	Buzz Driving Screener	BUZZED DRIVING SCREENING REVISED_070616.docx		No		Fillable Fileable
Form	NHTSA Form 1336	Moderators Guide	NHTSA Comm Checks Moderators Guide_070616 (003).docx		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 54	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	54	54
Annual IC Time Burden (Hours)	90	90
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Request	NHTSA Buzzed Comm Checks Fast Track Clearance Request_071116.docx	09/02/2016
Buzzed Cog NHTSA	Buzzed Cog NHTSA 09.01.16 [CT edit].pdf	09/02/2016

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