Information Collection

Drug Impaired Research

IC 232503 under ICR 201608-2105-003 · OMB 2105-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0573 can be found here:

Documents and Forms

Document Name Document Type
Form 1472 Drug Impaired Research Form
Drug Impaired Driving Discussion Guide_Revised_6.25.18_for NHTSA Review..._.docx Instruction
1472 Screener Guide Drug Impaired Driving Screener_Revised 6.22.18_for NHTSA Review (003).docx Form
Drug Impaired Driving Discussion Guide_Revised_6.25.18_for NHTSA Review..._.docx Discussion Guide IC Document
Drug Impaired Driving Screener_Revised 6.22.18_for NHTSA Review (003).docx Screener Questions IC Document
NHTSA Drug Impaired Research Generic Clearance Revised 7.11.18.docx Generic Clearance Request IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Drug Impaired Research	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	1472	Screener Guide	Drug Impaired Driving Screener_Revised 6.22.18_for NHTSA Review (003).docx		No		Paper Only
Instruction			Drug Impaired Driving Discussion Guide_Revised_6.25.18_for NHTSA Review..._.docx		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 346	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	346	346
Annual IC Time Burden (Hours)	104	104
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Discussion Guide	Drug Impaired Driving Discussion Guide_Revised_6.25.18_for NHTSA Review..._.docx	08/01/2018
Screener Questions	Drug Impaired Driving Screener_Revised 6.22.18_for NHTSA Review (003).docx	08/01/2018
Generic Clearance Request	NHTSA Drug Impaired Research Generic Clearance Revised 7.11.18.docx	08/01/2018

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