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⚠️ Notice: This information collection may be referencing outdated material.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 1384 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Form
NHTSA Form 1384 Online Survey Questionnaire - Impaired Driving Public Se Impaired Driving Online Survey Instrument__revised 12.21.16_FINAL.doc Form
Fast Track Clearance Request_Impaired Driving_ OnlineSurvey_Revised 12.21.16_FINAL.docx Generic Clearance Request 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 1384	Online Survey Questionnaire - Impaired Driving Public Service Advertising Campaign	Impaired Driving Online Survey Instrument__revised 12.21.16_FINAL.doc		Yes	Yes	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,200	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,200	1,200
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Request	Fast Track Clearance Request_Impaired Driving_ OnlineSurvey_Revised 12.21.16_FINAL.docx	12/22/2016

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