Information Collection

Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign

IC 198920 under ICR 201012-2127-003 · OMB 2127-0667.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0667 can be found here:

Documents and Forms

Document Name Document Type
Form NHTSA Form 1153 Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign Form and Instruction
NHTSA Form 1153 CPS Hispanic Comm Checks Moderators Guide English CPS Hispanic Comm Checks Moderators Guide in English 8 02 11.docx Form and Instruction
NHTSA Form 1154 CPS Hispanic Comm Checks Moderators Guide Spanish CPS Hispanic Comm Checks Moderator Guide in Spanish 8 02 11.docx Form and Instruction
NHTSA 1155 CPS Hispanic Comm Checks Screener English CPS Hispanic Comm Checks Screener in English 092311.docx Form
NHTSA 1156 CPS Hispanic Comm Checks Screener Spanish CPS Hispanic Comm Checks Screener Spanish092311.docx Form
CPS Hispanic Comm Checks Supporting Statement 7 19 11.docx Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign	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 and Instruction	NHTSA Form 1153	CPS Hispanic Comm Checks Moderators Guide English	CPS Hispanic Comm Checks Moderators Guide in English 8 02 11.docx	No	Fillable Printable
Form and Instruction	NHTSA Form 1154	CPS Hispanic Comm Checks Moderators Guide Spanish	CPS Hispanic Comm Checks Moderator Guide in Spanish 8 02 11.docx	No	Fillable Printable
Form	NHTSA 1155	CPS Hispanic Comm Checks Screener English	CPS Hispanic Comm Checks Screener in English 092311.docx	No	Fillable Printable
Form	NHTSA 1156	CPS Hispanic Comm Checks Screener Spanish	CPS Hispanic Comm Checks Screener Spanish092311.docx	No	Fillable Printable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 126	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	126	126
Annual IC Time Burden (Hours)	93	93
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign	CPS Hispanic Comm Checks Supporting Statement 7 19 11.docx	08/17/2011

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