Information Collection

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

IC 230186 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⚠️ Notice: This information collection may be referencing outdated material.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 1433 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction
NHTSA Form 1433 CIOT Recruitment Screener 2018 ClickIt Recruiting Screener - FINAL.doc	Form and Instruction
NHTSA Form 1434 CIOT Moderators Guide 2018 ClickIt Moderators Guide - FINAL.doc	Form and Instruction
No Good Excuse script CONCEPT A - 2-15-2018.docx No Good Excuse Script - Concept A	IC Document
Officer Mom script CONCEPT B - 2-15-2018.pdf Officer Mom Script - Concept B	IC Document
Surprise Ending script CONCEPT C - 2-15-2018.pdf Surprise Ending Script - Concept C	IC Document
The Search script CONCEPT D - 2-15-2018.docx The Search Script - Concept D	IC Document
CIOT Generic Clearance Request.docx CIOT Generic Clearance	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 and Instruction	NHTSA Form 1433	CIOT Recruitment Screener	2018 ClickIt Recruiting Screener - FINAL.doc		No		Paper Only
Form and Instruction	NHTSA Form 1434	CIOT Moderators Guide	2018 ClickIt Moderators Guide - FINAL.doc		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 48

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	48	48
Annual IC Time Burden (Hours)	62	62
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No Good Excuse Script - Concept A	No Good Excuse script CONCEPT A - 2-15-2018.docx	02/20/2018
Officer Mom Script - Concept B	Officer Mom script CONCEPT B - 2-15-2018.pdf	02/20/2018
Surprise Ending Script - Concept C	Surprise Ending script CONCEPT C - 2-15-2018.pdf	02/20/2018
The Search Script - Concept D	The Search script CONCEPT D - 2-15-2018.docx	02/20/2018
CIOT Generic Clearance	CIOT Generic Clearance Request.docx	02/20/2018

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