2006 Hispanic/Latino Adult Tobacco Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0726 Justification.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2007-07-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
43616	2006 Hispanic/Latino Adult Tobacco Survey	Instruction	Modified
181378	Modification to El Paso Tx Survey instrument	Instruction	New

ICR Details

OMB Control No: 0920-0726	ICR Reference No: 200707-0920-007
Status: Historical Active	Previous ICR Reference No: 200603-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: 2006 Hispanic/Latino Adult Tobacco Survey
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/03/2007
	Date Received in OIRA: 07/31/2007
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2008	08/31/2008	08/31/2008
Responses	5,000	0	4,250
Time Burden (Hours)	2,233	0	1,833
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this project is to develop and implement a culturally appropriate Adult Tobacco Survey among Hispanic/Latino subgroups in New York, Florida, and Texas.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
2006 Hispanic/Latino Adult Tobacco Survey
Modification to El Paso Tx Survey instrument

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	5,000	4,250	0	750	0	0
Annual Time Burden (Hours)	2,233	1,833	0	400	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Some of the questions originally approved were re-worded to make the survey easier to understand. Several questions were added as well.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 07/31/2007

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