Information Collection

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

IC 235796 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⚠️ Notice: This information collection may be referencing outdated material.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 1490 Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery	Form and Instruction
NHTSA Form 1490 Drugged Driving Recruiting Screener Drugged Driving Recruiting Screener 041119.docx	Form and Instruction
NHTSA Form 1491 Drugged Driving Moderators Guide Drugged Driving mod guide 041119.docx	Form and Instruction
Drugged Driving Generic Clearance 042219.docx Drugged Driving Generic Clearance	IC Document
DRUGGED DRIVING 2019 - PILLS creative1_4-15-19.pdf Drugged Driving 2019 - Pills Creative	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 1490	Drugged Driving Recruiting Screener	Drugged Driving Recruiting Screener 041119.docx		No		Fillable Fileable
Form and Instruction	NHTSA Form 1491	Drugged Driving Moderators Guide	Drugged Driving mod guide 041119.docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,590

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	1,590	1,590
Annual IC Time Burden (Hours)	1,590	1,590
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Drugged Driving Generic Clearance	Drugged Driving Generic Clearance 042219.docx	04/22/2019
Drugged Driving 2019 - Pills Creative	DRUGGED DRIVING 2019 - PILLS creative1_4-15-19.pdf	04/22/2019

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