National Adult Tobacco Survey Questionnaire

Health Marketing

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0798 can be found here:

Documents and Forms

Document Name Document Type
National Adult Tobacco Survey Questionnaire - English.doc Other-Telephone Survey
NATS Pre-Test Request 07 23 09.doc Supporting Statement IC Document

Information Collection (IC) Details

IC Title:	National Adult Tobacco Survey Questionnaire	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
Other-Telephone Survey			National Adult Tobacco Survey Questionnaire - English.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 963	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	963	0	0	0	0	0
Annual IC Time Burden (Hours)	137	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	NATS Pre-Test Request 07 23 09.doc	09/10/2009

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