Information Collection

NHTSA_CCS_2019 Communications Checks

IC 236790 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⚠️ Notice: This information collection may be referencing outdated material.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 1436 NHTSA_CCS_2019 Communications Checks	Form
NHTSA Form 1306 Online Study Screener NHTSA_CCS_2019_Communication Checks Screener_061219 (002).docx	Form
NHTSA Form 1436 Online Survey Questions NHTSA_CCS_2019_Communication Checks Questionnaire_061219 (002).docx	Form
NHTSA_CCS_2019_Communications Checks Generic Clearance_062419.docx NHTSA_CCS_2019_Communication Checks Generic Clearance	IC Document
AdCouncilNHTSA_6.12.19.pdf AdCouncil	IC Document

IC Title:

NHTSA_CCS_2019 Communications Checks

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	NHTSA Form 1436	Online Survey Questions	NHTSA_CCS_2019_Communication Checks Questionnaire_061219 (002).docx		Yes	Yes	Fillable Fileable
Form	NHTSA Form 1306	Online Study Screener	NHTSA_CCS_2019_Communication Checks Screener_061219 (002).docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 500

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	500	500
Annual IC Time Burden (Hours)	25	25
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
NHTSA_CCS_2019_Communication Checks Generic Clearance	NHTSA_CCS_2019_Communications Checks Generic Clearance_062419.docx	07/02/2019
AdCouncil	AdCouncilNHTSA_6.12.19.pdf	07/02/2019

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