Information Collection

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

IC 227982 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⚠️ Notice: This information collection may be referencing outdated material.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 1413 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form
NHTSA Form 1413 Drunk Driver Concepts Screener 2017 Drunk Driving Concepts Screener Aug2 (003).doc	Form
NHTSA Form 1414 Drunk Driving Moderators Guide 2017 Drunk Driving mod guide (003) sm.doc	Form and Instruction
2017 Drunk Driving Generic Clearance.docx 2017 Drunk Driving Generic Clearance	IC Document
Scripts to Test.docx 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 1413	Drunk Driver Concepts Screener	2017 Drunk Driving Concepts Screener Aug2 (003).doc		No		Fillable Fileable
Form and Instruction	NHTSA Form 1414	Drunk Driving Moderators Guide	2017 Drunk Driving mod guide (003) sm.doc		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 104

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	104	104
Annual IC Time Burden (Hours)	126	126
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
2017 Drunk Driving Generic Clearance	2017 Drunk Driving Generic Clearance.docx	08/22/2017
Scripts	Scripts to Test.docx	08/22/2017

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