Information Collection

2006 Hispanic/Latino Adult Tobacco Survey

IC 43616 under ICR 200707-0920-007 · OMB 0920-0726.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
H-L ATS Questionnaire (English)_El_Paso.doc	Instruction
H-L ATS Questionnaire (All Spanish)_El_Paso.doc	Instruction
H-L ATS Questionnaire tracked changes.doc Tracked change instrument	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
Instruction			H-L ATS Questionnaire (All Spanish)_El_Paso.doc		Yes	Yes	Printable Only
Instruction			H-L ATS Questionnaire (English)_El_Paso.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,250

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 66 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	4,250	4,250
Annual IC Time Burden (Hours)	1,833	1,833
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Tracked change instrument	H-L ATS Questionnaire tracked changes.doc	07/13/2007

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