Information Collection

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

IC 234449 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⚠️ Notice: This information collection may be referencing outdated material.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 1485 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form
NHTSA Form 1485 Drug Impaired Driving Screener Drug Impaired Driving Screener_12.5.18.docx	Form
NHTSA Form 1486 Drug Impaired Moderators Guide NHTSA Comm Checks Moderators Guide_Drug Impaired_12.07.18.docx	Form and Instruction
NHTSA Drug Impaired Focus Group Research Generic Clearance 12.5.18.docx Generic Cleaance Request	IC Document
AdCouncil_CreativeConcepts_for OMB.PDF AdCouncil_Creative Concepts	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 1485	Drug Impaired Driving Screener	Drug Impaired Driving Screener_12.5.18.docx		No		Paper Only
Form and Instruction	NHTSA Form 1486	Drug Impaired Moderators Guide	NHTSA Comm Checks Moderators Guide_Drug Impaired_12.07.18.docx		No		Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 461

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	461	461
Annual IC Time Burden (Hours)	94	94
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Cleaance Request	NHTSA Drug Impaired Focus Group Research Generic Clearance 12.5.18.docx	12/10/2018
AdCouncil_Creative Concepts	AdCouncil_CreativeConcepts_for OMB.PDF	12/10/2018

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