Information Collection

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

IC 239859 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⚠️ Notice: This information collection may be referencing outdated material.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 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

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	Available 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

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 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	145	145
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.