Information Collection

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

IC 224676 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⚠️ Notice: This information collection may be referencing outdated material.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 1383 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form
NHTSA Form 1383 DBE Questionnaire OST File_DBE Questionnaire_11302016.docx	Form
updated fast-track-PRA-submission-short-form.doc Generic Clearance Request	IC Document
US DOT DBE Summit 2016- Name Badges 427pm.xlsx DBE Name Badge Listing	IC Document
DBE Summit Agenda (Final).docx DBE Summit Agenda	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 1383	DBE Questionnaire	OST File_DBE Questionnaire_11302016.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 320

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	320	320
Annual IC Time Burden (Hours)	320	320
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Clearance Request	updated fast-track-PRA-submission-short-form.doc	12/01/2016
DBE Name Badge Listing	US DOT DBE Summit 2016- Name Badges 427pm.xlsx	12/01/2016
DBE Summit Agenda	DBE Summit Agenda (Final).docx	12/01/2016

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