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Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 2127-0682
IC ID: 239859
OMB.report
DOT/NHTSA
OMB 2127-0682
ICR 201804-2127-006
IC 239859
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0682 can be found here:
2022-05-05 - Reinstatement without change of a previously approved collection
Documents and Forms
Document Name
Document Type
Form NHTSA Form 1540
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Form and Instruction
NHTSA Form 1540 Discusssion Guide
DRIVE SOBER - Discussion Guide_Draft 2020.01.24.docx
Form and Instruction
NHTSA Form 1541 Discussion Guide - Spanish
DRIVE SOBER - Mod Guide 012420 SPANISH.docx
Form and Instruction
NHTSA Form 1542 Recruitment Screener
DRIVE SOBER - Screener 2020.01.24.docx
Form
NHTSA Form 1543 Recruitment Screener - Spanish
DRIVE SOBER - Screener 2020.01.15 SPANISH.docx
Form
DRIVE SOBER - Screener 010720 SPANISH back translation.docx
Recruitment Screener - Spanish Translation
IC Document
Drive Sober Scripts 1_23_rev.docx
Creative Scripts
IC Document
DRIVE SOBER - NHTSA Generic Clearance Submission Draft 2020.01.24.docx
Generic Clearance Request
IC Document
Information Collection (IC) Details
View Information Collection (IC)
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:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
NHTSA Form 1540
Discusssion Guide
DRIVE SOBER - Discussion Guide_Draft 2020.01.24.docx
No
Paper Only
Form and Instruction
NHTSA Form 1541
Discussion Guide - Spanish
DRIVE SOBER - Mod Guide 012420 SPANISH.docx
No
Printable Only
Form
NHTSA Form 1542
Recruitment Screener
DRIVE SOBER - Screener 2020.01.24.docx
No
Fillable Fileable
Form
NHTSA Form 1543
Recruitment Screener - Spanish
DRIVE SOBER - Screener 2020.01.15 SPANISH.docx
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
500
0
500
0
0
0
Annual IC Time Burden (Hours)
145
0
145
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Recruitment Screener - Spanish Translation
DRIVE SOBER - Screener 010720 SPANISH back translation.docx
02/06/2020
Creative Scripts
Drive Sober Scripts 1_23_rev.docx
02/06/2020
Generic Clearance Request
DRIVE SOBER - NHTSA Generic Clearance Submission Draft 2020.01.24.docx
02/06/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.