Information Collection

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

IC 233955 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⚠️ Notice: This information collection may be referencing outdated material.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 1384 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction
NHTSA Form 1384 Impaired Driving Survey Impaired Driving Survey Instrument_11.08.18.doc	Form and Instruction
Fast Track Clearance Request_Impaired Driving_ OnlineSurvey_10.9.18.docx Fast Track Clearance Request Impaired Driving	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 and Instruction	NHTSA Form 1384	Impaired Driving Survey	Impaired Driving Survey Instrument_11.08.18.doc		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,200

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	1,200	1,200
Annual IC Time Burden (Hours)	300	300
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Fast Track Clearance Request Impaired Driving	Fast Track Clearance Request_Impaired Driving_ OnlineSurvey_10.9.18.docx	11/28/2018

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