Information Collection

Focus Groups for Increasing Safety Belt Use Among Rural Populations

IC 236523 under ICR 201804-2127-006 · OMB 2127-0682.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2127-0682 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form NHTSA Form 1487 Focus Groups for Increasing Safety Belt Use Among Rural Populations	Form and Instruction
NHTSA Form 1487 PRG Community Member Focus Group Moderator's Guide PRG Community Member Focus Group Moderator's Guide - Final.docx	Form and Instruction
NHTSA Form 1488 PRG Screner for Recruiting PRG Screener Guide for Recruiting - FINAL 5.09.2019_wcedits.docx	Form
OMB Request for Approval - FINAL 4.09.2019_wcedits (002).docx Generic Approval Request	IC Document

IC Title:

Focus Groups for Increasing Safety Belt Use Among Rural Populations

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.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	NHTSA Form 1487	PRG Community Member Focus Group Moderator's Guide	PRG Community Member Focus Group Moderator's Guide - Final.docx		No		Paper Only
Form	NHTSA Form 1488	PRG Screner for Recruiting	PRG Screener Guide for Recruiting - FINAL 5.09.2019_wcedits.docx		No		Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

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	90	90
Annual IC Time Burden (Hours)	135	135
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Generic Approval Request	OMB Request for Approval - FINAL 4.09.2019_wcedits (002).docx	06/17/2019

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