Information Collection

Underage Alcohol Use Prevention Media Campaign Focus Groups

IC 192336 under ICR 200706-0930-004 · OMB 0930-0196.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0196 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form Attachment 3 - Mal Underage Alcohol Use Prevention Media Campaign Focus Groups	Form
Attachment 3 - Mal Attachment 3 - Male Screener Attachment3 Male Recruit-Screener 3-18-10_Final.doc	Form
Attachment 2 - Fem Attachment 2 - Female Screener Attachment2 Female Recruit-Screener 3-18-10_Final.doc	Form
Attachment6 Use of Telephone Focus Groups 3-15-10_Final.pdf Attachment 6 - Use of Telephone Focus Groups	IC Document
Attachment5 Message Concepts for Testing 3-18-10_Final.doc Attachment 5 - Message Concepts	IC Document
Attachment4 Focus Group Moderator Guide 3-18-10_Final.doc Attachment 4 - Moderator's Guide	IC Document
Attachment1 Focus Group Plan 3-18-10_Final.doc Attachment 1 - Focus Group Plan	IC Document
Terms of Clearance 0930-0196_Underage Alcohol Use Prevention Media Campaign Focus Groups.doc Terms of Clearance	IC Document

IC Title:

Underage Alcohol Use Prevention Media Campaign Focus Groups

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	Attachment 3 - Male Screener	Attachment 3 - Male Screener	Attachment3 Male Recruit-Screener 3-18-10_Final.doc		Yes	Yes	Paper Only
Form	Attachment 2 - Female Screener	Attachment 2 - Female Screener	Attachment2 Female Recruit-Screener 3-18-10_Final.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 600

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 50 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	72	72
Annual IC Time Burden (Hours)	102	102
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 6 - Use of Telephone Focus Groups	Attachment6 Use of Telephone Focus Groups 3-15-10_Final.pdf	03/18/2010
Attachment 5 - Message Concepts	Attachment5 Message Concepts for Testing 3-18-10_Final.doc	03/18/2010
Attachment 4 - Moderator's Guide	Attachment4 Focus Group Moderator Guide 3-18-10_Final.doc	03/18/2010
Attachment 1 - Focus Group Plan	Attachment1 Focus Group Plan 3-18-10_Final.doc	03/18/2010
Terms of Clearance	Terms of Clearance 0930-0196_Underage Alcohol Use Prevention Media Campaign Focus Groups.doc	04/13/2010

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