Information Collection

CPSC DEI Focus Group: Hispanic Consumer Study

IC 254029 under ICR 202305-3041-001 · OMB 3041-0136.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 3041-0136 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Pre-Screen_Focus Group Recruitment_CPSC.pdf	Other-
Pre-Screen_Focus Group Recruitment_CPSC.pdf	Other-
DEI Focus Group_Consent Form.pdf	Other-
DEI Focus Group_Consent Form.pdf	Other-
DEI HA Guide_CPSC.pdf	Other-
DEI HA Guide_CPSC.pdf	Other-
DEI Creative Stimuli_CPSC.pdf	Other-
DEI Creative Stimuli_CPSC.pdf	Other-
DEI Focus Group_Supporting Statement.pdf Supporting Statement	IC Document
DEI Focus Group_Supporting Statement.pdf Supporting Statement	IC Document
DEI Focus Group_Confirmation Letter- Virtual Facility.pdf Confirmation Letter	IC Document
DEI Focus Group_Confirmation Letter- Virtual Facility.pdf Confirmation Letter	IC Document

IC Title:

CPSC DEI Focus Group: Hispanic Consumer Study

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-	Pre-Screen_Focus Group Recruitment_CPSC.pdf	No		Paper Only
Other-	DEI Focus Group_Consent Form.pdf	Yes	Yes	Fillable Fileable
Other-	DEI HA Guide_CPSC.pdf	No		Paper Only
Other-	DEI Creative Stimuli_CPSC.pdf	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 100

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	100	100
Annual IC Time Burden (Hours)	34	34
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement	DEI Focus Group_Supporting Statement.pdf	06/03/2022
Confirmation Letter	DEI Focus Group_Confirmation Letter- Virtual Facility.pdf	06/03/2022

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