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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1153 CPS Hispanic Comm Checks Moderators Guide English Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign	Form and Instruction
Form NHTSA Form 1154 CPS Hispanic Comm Checks Moderators Guide Spanish Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign	Form and Instruction
Form NHTSA 1155 CPS Hispanic Comm Checks Screener English Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign	Form
Form NHTSA 1156 CPS Hispanic Comm Checks Screener Spanish Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign	Form
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

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:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 1153	No	Fillable Printable
Form and Instruction	NHTSA Form 1154	No	Fillable Printable
Form	NHTSA 1155	No	Fillable Printable
Form	NHTSA 1156	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 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
Hispanic Parent & Caregiver Focus Groups to Develop New Child Passenger Safety Public Service Advertising Campaign		08/17/2011

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

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