Information Collection

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

IC 221486 under ICR 201504-2125-005 · OMB 2125-0628.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2125-0628 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FHWA 1647 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form
FHWA 1647 NHI User Satisfaction Survey NHI_SurveyQuestions_ NHI Marketing Satisfaction 042716.docx	Form
Generic Clearance Form NHI User Satisfaction.pdf.docx Fast Track Application	IC Document
Fast-Track Generic Clearance Checklist_NHI User Satisfaction.docx Fast Track Checklist	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	FHWA 1647	NHI User Satisfaction Survey	NHI_SurveyQuestions_ NHI Marketing Satisfaction 042716.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

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	100	100
Annual IC Time Burden (Hours)	17	17
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Application	Generic Clearance Form NHI User Satisfaction.pdf.docx	05/12/2016
Fast Track Checklist	Fast-Track Generic Clearance Checklist_NHI User Satisfaction.docx	05/12/2016

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