Survey for Seat Belt Safety Public Service Advertising Campaign

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2105-0573 can be found here:

Documents and Forms

Document Name Document Type
Fast Track Clearance Request_Tween Seat Belt Safety_Online Survey_7.3.18.._.docx Instruction
Tween Seat Belt Safety Survey_6.28.18.docx Other-Survey Questions

Information Collection (IC) Details

IC Title:	Survey for Seat Belt Safety Public Service Advertising Campaign	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Fast Track Clearance Request_Tween Seat Belt Safety_Online Survey_7.3.18.._.docx		Yes	Yes	Fillable Fileable
Other-Survey Questions			Tween Seat Belt Safety Survey_6.28.18.docx		Yes	Yes	Fillable Fileable

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,900	Number of Respondents for Small Entity: 100

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Previously Approved
Annual Number of Responses for this IC	3,900	3,900
Annual IC Time Burden (Hours)	215	215
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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