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Drug Impaired Research
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
OMB: 2105-0573
IC ID: 232503
OMB.report
DOT/OST
OMB 2105-0573
ICR 201906-2105-001
IC 232503
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0573 can be found here:
2022-08-31 - Revision of a currently approved collection
2022-05-13 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
Form 1472
Drug Impaired Research
Form
Drug Impaired Driving Discussion Guide_Revised_6.25.18_for NHTSA Review..._.docx
Instruction
1472 Screener Guide
Drug Impaired Driving Screener_Revised 6.22.18_for NHTSA Review (003).docx
Form
Drug Impaired Driving Discussion Guide_Revised_6.25.18_for NHTSA Review..._.docx
Discussion Guide
IC Document
Drug Impaired Driving Screener_Revised 6.22.18_for NHTSA Review (003).docx
Screener Questions
IC Document
NHTSA Drug Impaired Research Generic Clearance Revised 7.11.18.docx
Generic Clearance Request
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Drug Impaired Research
Agency IC Tracking Number:
IC Status:
Unchanged
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
1472
Screener Guide
Drug Impaired Driving Screener_Revised 6.22.18_for NHTSA Review (003).docx
No
Paper Only
Instruction
Drug Impaired Driving Discussion Guide_Revised_6.25.18_for NHTSA Review..._.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Transportation
Subfunction:
Ground Transportation
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
346
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Requested
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
346
0
0
0
0
346
Annual IC Time Burden (Hours)
104
0
0
0
0
104
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Discussion Guide
Drug Impaired Driving Discussion Guide_Revised_6.25.18_for NHTSA Review..._.docx
08/01/2018
Screener Questions
Drug Impaired Driving Screener_Revised 6.22.18_for NHTSA Review (003).docx
08/01/2018
Generic Clearance Request
NHTSA Drug Impaired Research Generic Clearance Revised 7.11.18.docx
08/01/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.