View Information Collection (IC)

View Information Collection (IC)

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	NHTSA Form 1383	DBE Questionnaire	OST File_DBE Questionnaire_11302016.docx		Yes	Yes	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: 320	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	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	320	0	320	0	0	0
Annual IC Time Burden (Hours)	320	0	320	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Generic Clearance Request	updated fast-track-PRA-submission-short-form.doc	12/01/2016
DBE Name Badge Listing	US DOT DBE Summit 2016- Name Badges 427pm.xlsx	12/01/2016
DBE Summit Agenda	DBE Summit Agenda (Final).docx	12/01/2016

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