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

THIS COMMENT FORM WILL BE A POP-UP ON THE FHWA CONDITIONS AND PERFORMANCE WEB PAGE.

The OMB Burden Statement will be displayed prior to accessing the customer comment form.

This collection of information is voluntary and will be used to help FHWA learn more about our users interests and view of the current C&P Report. Public reporting burden is estimated to average 15 minutes per response, including the time for reviewing instructions searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this collection is 2125-0628. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, Michael Howell, [email protected], 202 366-5707, Federal Highway Administration, E64-433, 1200 New Jersey Avenue, SE, Washington, DC 20590.

Dear Reader,

We want to learn more about your interests and view of the current C&P Report.  We also would like your suggestions as to how we can improve future editions of the report.  Please help us by taking a few minutes to answer the questions below.   All responses are voluntary. 

1. Which of the following best describes your affiliation (select one)?

   1. State Legislature (Member Office or Committee)

   2. State Transportation Commission or  Transportation Agency

   3. County, Municipality, Township, or Special Highway District

   4. Metropolitan or Regional Planning Organization

   5. Transit Operator

   6. Industry or Trade Association

   7. University, Academia, Public Policy, or Research Organization

   8. News Media and/or Press Organization

   9. Consulting firm

   10. Users of system and their interest groups

   11. International government agency

   12. Other (please describe) ____________________

2. Which travel mode in the C&P Report is of most interest to you?

   1. Highway

   2. Transit

   3. Both

3. Which topics in the C&P Report are of most interest to you?

   1. Current System Operations and Performance

   2. Current System Finance

   3. Current System Conditions/State of Good Repair

   4. Future Investment Impacts – Scenario Analysis

   5. Other (please describe) ______________________

   6. All of the above

4. Which job title below best represents your current role and/or responsibilities?

1. Executive

2. Manager

3. Analyst

4. Researcher

5. Journalist

6. Engineer

7. Transportation Planner

8. Attorney and/or Representative

9. Other (please describe) ______________________

5. How did you learn about the C&P Report?

   1. Visit to web site

   2. Press release

   3. Referral from colleague

   4. Referred to in another publication or blog

   5. Posting on social media (e.g., Facebook, Twitter)

   6. Other (please describe) ______________________

6. Have you read previous editions of the C&P Report?

   1. Yes

   2. No

   3. Don’t recall

7. How do you prefer to view future editions of the C&P Report?

   1. Print version

   2. Online version

   3. Either option is fine

8. Please provide any additional comments and suggestions in the space provided below.

9. Would you be interested in discussing your interests and views further?  If so, please provide your name and e-mail in the space below.

Name:

Business E-mail address: 

Thank you for taking time to answer our questions.  Please submit your response via e-mail to C&[email protected] or call 202-366-9233 for further information.