Form NHTSA Form 1010 NHTSA Form 1010 National Survey of the Use of Booster Seats

OMB Control No. 2127-0644

Expiration Date xx/xx/xxxx

Survey Information

WESTAT, Rockville MD 20850

(301)251-1500

Paperwork Reduction Act Burden Statement

A Federal Agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0644. Public reporting for this collection of information is estimated to be approximately (4) minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, NHTSA, 1200 New Jersey Avenue, SW, Washington, DC 20590.

NHTSA Form 1010