View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Collection of Qualitative Feedback on Agency Service Delivery on Tween Seat Belt Safety	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	NHTSA Form 1722	Online Survey Questionnaire Tween Public Service Advertising Campaign	Ad Council Tween Seat Belt Safety Q're_7.28.23.docx		Yes	Yes	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Transportation

Subfunction: Ground Transportation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	1,000	0	1,000	0	0	0
Annual IC Time Burden (Hours)	233	0	233	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Collection of Qualitative Feedback on Agency Service Delivery Tween Seat Belt Safety	Fast Track Clearance Request_Tween CPS_Tracking Study_6.21.23.docx	08/01/2023

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