Information Collection Request

Psychological Constructs Related to Seat Belt Use

ICR 201708-2127-001 · OMB 2127-0729 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1366 Psychological Constructs Related to Seat Belt Use Complete Survey Form and Instruction New Available
Form 1365 Psychological Constructs Related to Seat Belt Use Survey Screener Form and Instruction New Available
PCRSBU Appendix C Privacy Statement.docx Supplementary Document Uploaded 2018-02-16 Repair queued
PCRSBU Appendix B Question Justification.docx Supplementary Document Uploaded 2018-02-16 Available
PCRSBU PRA Section A 021618.docx Supporting Statement A Uploaded 2018-02-16 Available
PCRSBU App A Participant Email Invitation 060117.doc Supplementary Document Uploaded 2017-08-10 Available
PCRSBU PRA Section B 060117.docx Supporting Statement B Uploaded 2017-08-10 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
227885 Psychological Constructs Related to Seat Belt Use Complete Survey Form and Instruction New
227882 Psychological Constructs Related to Seat Belt Use Survey Screener Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2021 36 Months From Approved
16,197 0 0
2,070 0 0
53,285 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
Psychological Constructs Related to Seat Belt Use Survey Screener 1365 Survey Screener
Psychological Constructs Related to Seat Belt Use Complete Survey 1366 Complete Survey

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 16,197 0 0 16,197 0 0
Annual Time Burden (Hours) 2,070 0 0 2,070 0 0
Annual Cost Burden (Dollars) 53,285 0 0 53,285 0 0


Reginfo record details
  No