Information Collection

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

IC 232813 under ICR 201804-2127-006 · 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⚠️ Notice: This information collection may be referencing outdated material.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 1467 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form
NHTSA Form 1467 Drugged Driving Screener - Spanish Drugged Driving Screener SPANISH GM_071718.docx	Form
NHTSA Form 1477 Drugged Driving Moderators Guide - Spanish Drugged Driving Mod Guide SPANISH GM_071718.doc	Form and Instruction
Hispanic Drug Impaired Driving Scripts for Testing.docx Hispanic Driving Scripts	IC Document
DrugImpaired_C1W_Selects V4.pdf Drug Impaired C1W Selects	IC Document
Drugged Driving Generic Clearance SPANISH lgm 08 23_.docx Generic Clearance Request	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	NHTSA Form 1467	Drugged Driving Screener - Spanish	Drugged Driving Screener SPANISH GM_071718.docx		No		Paper Only
Form and Instruction	NHTSA Form 1477	Drugged Driving Moderators Guide - Spanish	Drugged Driving Mod Guide SPANISH GM_071718.doc		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 424

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	424	424
Annual IC Time Burden (Hours)	61	61
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Hispanic Driving Scripts	Hispanic Drug Impaired Driving Scripts for Testing.docx	08/24/2018
Drug Impaired C1W Selects	DrugImpaired_C1W_Selects V4.pdf	08/24/2018
Generic Clearance Request	Drugged Driving Generic Clearance SPANISH lgm 08 23_.docx	08/24/2018

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