Information Collection

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

IC 224002 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⚠️ Notice: This information collection may be referencing outdated material.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 1367 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form
NHTSA Form 1367 Recruitment Screener for Focus Groups Drugged Driving3 Screener 100316_Final.docx	Form
NHTSA Form 1368 Moderator's Guide for Fcous Groups Drugged Driving3 mod guide 101216_Final.doc	Form and Instruction
Drugged Driving Generic Clearance3 100316 Final 10192016.docx Drugged Driving Cleaance3	IC Document
Drugged Driving Scripts 10.6.docx Drugged Driving Scripts	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 1367	Recruitment Screener for Focus Groups	Drugged Driving3 Screener 100316_Final.docx		No		Paper Only
Form and Instruction	NHTSA Form 1368	Moderator's Guide for Fcous Groups	Drugged Driving3 mod guide 101216_Final.doc		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 60

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	60	60
Annual IC Time Burden (Hours)	66	66
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Drugged Driving Cleaance3	Drugged Driving Generic Clearance3 100316 Final 10192016.docx	10/19/2016
Drugged Driving Scripts	Drugged Driving Scripts 10.6.docx	10/19/2016

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