Information Collection

2020 Distracted Driving Campaign Focus Groups

IC 237290 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Form NHTSA Form 1515 2020 Distracted Driving Campaign Focus Groups Form
NHTSA Form 1515 Distracted Driving Screener 08052019 GENERAL MARKET Distracted Driving Screener 08052019 GENERAL MARKET.docx Form
NHTSA Form 1516 Distracted Driving Screener 08052019 SPANISH (002).docx Distracted Driving Screener 08052019 SPANISH (002).docx Form
NHTSA Form 1517 Distracted Driving Mod Guide 08052019 SPANISH Distracted Driving Mod Guide 08052019 SPANISH.docx Form and Instruction
NHTSA Form 1518 Distracted Driving Mod Guide 08052019 GENERAL MARKET AND Distracted Driving Mod Guide 08052019 GENERAL MARKET AND SPANISH BACK TRANSLATION.docx Form and Instruction
nhtsa fORM 1519 Distracted Driving Screener 08052019 SPANISH BACK TRANSL Distracted Driving Screener 08052019 SPANISH BACK TRANSLATION.docx Form
Distracted Driving Generic Clearance 08052019.docx Distracted Driving Generic Clearance IC Document
NHTSA_Spa Distracted_Concepts_08-05-19.pdf Distraction Concepts_Eng_with scripts IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	2020 Distracted Driving Campaign Focus Groups	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Electronic Capability
Form	NHTSA Form 1515	Distracted Driving Screener 08052019 GENERAL MARKET	Distracted Driving Screener 08052019 GENERAL MARKET.docx	No	Paper Only
Form	NHTSA Form 1516	Distracted Driving Screener 08052019 SPANISH (002).docx	Distracted Driving Screener 08052019 SPANISH (002).docx	No	Paper Only
Form and Instruction	NHTSA Form 1517	Distracted Driving Mod Guide 08052019 SPANISH	Distracted Driving Mod Guide 08052019 SPANISH.docx	No	Printable Only
Form and Instruction	NHTSA Form 1518	Distracted Driving Mod Guide 08052019 GENERAL MARKET AND SPANISH BACK TRANSLATION	Distracted Driving Mod Guide 08052019 GENERAL MARKET AND SPANISH BACK TRANSLATION.docx	No	Paper Only
Form	nhtsa fORM 1519	Distracted Driving Screener 08052019 SPANISH BACK TRANSLATION	Distracted Driving Screener 08052019 SPANISH BACK TRANSLATION.docx	No	Paper Only

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	289	289
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Distracted Driving Generic Clearance	Distracted Driving Generic Clearance 08052019.docx	08/08/2019
Distraction Concepts_Eng_with scripts	NHTSA_Spa Distracted_Concepts_08-05-19.pdf	08/08/2019

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