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

Forms and Documents

Document	Type	Status	Availability
Form NHTSA Form 1584 Texting and Driving	Form	New	Available
Form NHTSA Form 1272 Tween Seat Belt Safety Online Survey	Form	New	Repair queued
Form NHTSA Form 1512 Child Passenger Safety Online Survey	Form	New	Available
Form NHTSA Form 1574 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Repair queued
Form NHTSA Form 1540 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction	New	Repair queued
Form NHTSA Form 1536 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Available
Form NHTSA Form 1534 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Available
Form NHTSA Form 1532 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Available
Form NHTSA Fomr 1529 Qualitative Feedback on How to Communicate More Effectively with Consumers about Automated Driving Systems	Form	New	Repair queued
Form NHTSA Form 1520 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Available
Form NHTSA Form 1515 2020 Distracted Driving Campaign Focus Groups	Form	New	Available
Form NHTSA Form 1512 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Available
Form NHTSA Form 1436 NHTSA_CCS_2019 Communications Checks	Form	New	Available
Form NHTSA Form 1501 Collection of Qualitative Feedback on Effective Recall Communications for Office of Defects Investigation Recall Campaign Promotion.	Form	New	Available
Form NHTSA Form 1487 Focus Groups for Increasing Safety Belt Use Among Rural Populations	Form and Instruction	New	Repair queued
Form NHTSA Form 1490 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction	New	Available
Form NHTSA Form 1485 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Available
Form NHTSA Form 1489 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Available
Form NHTSA Form 1485 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Repair queued
Form NHTSA Form 1384 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction	New	Available
Form NHTSA Form 1479 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction	New	Repair queued
Form NHTSA Form 1467 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New	Repair queued
PRA-2127-0682_NHTSA_Fast_Track_Generic_Clearance_SubmissionTemplate[1].doc	Supplementary Document	Uploaded 2018-04-26	Available
PRA-2127-0682_NHTSA Fast Track Generic Clearance Part B_2018.docx	Supporting Statement B	Uploaded 2018-04-27	Available
PRA-2127_0682_NHTSA_Fast_Track_Generic_Clearance_Part_A_2018.doc	Supporting Statement A	Uploaded 2018-04-27	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
244306	Texting and Driving	Form	New
243961	Tween Seat Belt Safety Online Survey	Form	New
243742	Child Passenger Safety Online Survey	Form	New
242490	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
239859	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction	New
239242	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
238967	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
238786	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
238540	Qualitative Feedback on How to Communicate More Effectively with Consumers about Automated Driving Systems	Form	New
237678	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
237290	2020 Distracted Driving Campaign Focus Groups	Form	New
237108	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
236790	NHTSA_CCS_2019 Communications Checks	Form	New
236641	Collection of Qualitative Feedback on Effective Recall Communications for Office of Defects Investigation Recall Campaign Promotion.	Form	New
236523	Focus Groups for Increasing Safety Belt Use Among Rural Populations	Form and Instruction	New
235796	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction	New
235440	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
234999	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
234449	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New
233955	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction	New
233715	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction	New
232813	Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form	New

ICR Details

OMB Control No: 2127-0682	ICR Reference No: 201804-2127-006
Status: Active	Previous ICR Reference No: 201502-2127-002
Agency/Subagency: DOT/NHTSA	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/13/2018
	Date Received in OIRA: 04/28/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2021	36 Months From Approved	08/31/2018
Responses	113,582	0	113,582
Time Burden (Hours)	20,204	0	20,204
Cost Burden (Dollars)	0	0	135,820

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Abstract: This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders is voluntary and will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs. Our customers and stakeholders range from the individuals and households, businesses, organizations, state and local governments. There are no program changes or adjustment to be report with this renewal.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 1095	01/09/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 18393	04/26/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 22

IC Title	Form No.	Form Name
Texting and Driving	NHTSA Form 1584, NHTSA Form 1585	Texting and Driver Screener ,   Texing and Driving
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1574, NHTSA Form 1575	NHTSA Phase 2 OBB Screener ,   NHTSA Phase 2 OBB Discussion Guide
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1485	Drug Impaired Drving Survey
Collection of Qualitative Feedback on Effective Recall Communications for Office of Defects Investigation Recall Campaign Promotion.	NHTSA Form 1499, NHTSA Form 1498, NHTSA Form 1501, NHTSA Form 1500	ODI Recall Communications OBB Discussion Guide ,   ODI Recall Communications OBB Screener GenPop ,   ODI Recall Communications OBB Screener Hispanic ,   ODI Recall Communications OBB Screener Takata_FINAL_2019-04-22
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1467, NHTSA Form 1477	Drugged Driving Screener - Spanish ,   Drugged Driving Moderators Guide - Spanish
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1532, NHTSA Form 1533	ODI Recall Creative Testing OBB Screener ,   ODI Recall Creative Testing OMB Discussion Guide
Focus Groups for Increasing Safety Belt Use Among Rural Populations	NHTSA Form 1487, NHTSA Form 1488	PRG Community Member Focus Group Moderator's Guide ,   PRG Screner for Recruiting
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1512	Child Passenger Safety Wave
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1490, NHTSA Form 1491	Drugged Driving Recruiting Screener ,   Drugged Driving Moderators Guide
Tween Seat Belt Safety Online Survey	NHTSA Form 1272	Tween Seat Belt Safety Online Survey
NHTSA_CCS_2019 Communications Checks	NHTSA Form 1306, NHTSA Form 1436	Online Survey Questions ,   Online Study Screener
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1534, NHTSA Form 1535	ODI Air Bag Recall Creative Testing - Screener ,   ODI Air Bag Creative Testing - Discussion Guide
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1479, NHTSA Form 1480	Recruitment Screener ,   Moderators Guide
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1485, NHTSA Form 1486	Drug Impaired Driving Screener ,   Drug Impaired Moderators Guide
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1521, NHTSA Form 1520	NHTSA Comm Check Screener ,   NHTSA Comm Check Moderators Guide
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1536, NHTSA Form 1537	CIOT Screener ,   CIOT Discussion Guide
2020 Distracted Driving Campaign Focus Groups	NHTSA Form 1515, NHTSA Form 1517, NHTSA Form 1516, nhtsa fORM 1519, NHTSA Form 1518	Distracted Driving Screener 08052019 GENERAL MARKET ,   Distracted Driving Screener 08052019 SPANISH (002).docx ,   Distracted Driving Mod Guide 08052019 SPANISH ,   Distracted Driving Mod Guide 08052019 GENERAL MARKET AND SPANISH BACK TRANSLATION ,   Distracted Driving Screener 08052019 SPANISH BACK TRANSLATION
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1384	Impaired Driving Survey
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1489	DOT Transportation.gov 2019 Survey
Qualitative Feedback on How to Communicate More Effectively with Consumers about Automated Driving Systems	NHTSA Form 1530, NHTSA Fomr 1529, NHTSA Form 1531	ADS Consumer Education Research FG Screener ,   ADS Consumer EducationResearch FG Discussion Guide ,   ADS Consumer Education Research FG Workbook
Child Passenger Safety Online Survey	NHTSA Form 1512	Child Passenger Safety Wave
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	NHTSA Form 1540, NHTSA Form 1541, NHTSA Form 1542, NHTSA Form 1543	Discusssion Guide ,   Discussion Guide - Spanish ,   Recruitment Screener ,   Recruitment Screener - Spanish

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	113,582	113,582	0	0	0	0
Annual Time Burden (Hours)	20,204	20,204	0	0	0	0
Annual Cost Burden (Dollars)	0	135,820	0	-135,820	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $525,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 04/28/2018

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