Fall 2009 Media Tracking Survey(unretained for follow-up

Evaluation of the Parents Speak Up National Campaign: National Media Tracking Surveys

Documents and Forms

Document Name Document Type
Form 0990 Fall 2009 Media Tracking Survey(unretained for follow-up Form
0990 Debriefing 0990-PSUNC-Tracking Survey-Debriefing Form.doc Form
0990-PSUNC-TrackingSurvey-Knowledge Networks Panel Recruitment Methodology.doc 0990-PSUNC-TrackingSurvey-Knowledge Networks Panel Recruitment Methodology IC Document
0990-PSUNC-TrackingSurvey-Assurances of Confidentiality and Study Consent.doc 0990-PSUNC-TrackingSurvey-Assurances of Confidentiality and Study Consent IC Document
0990-PSUNC-TrackingSurvey-Knowledge Networks Privacy and Confidentiality Procedures.doc 0990-PSUNC-TrackingSurvey-Knowledge Networks Privacy and Confidentiality Procedures IC Document
0990-PSUNC-TrackingSurvey-RTI IRB Approval Notice 02-24-09.pdf IRB IC Document

Information Collection (IC) Details

IC Title:	Fall 2009 Media Tracking Survey(unretained for follow-up	Agency IC Tracking Number:

Is this a Common Form? No		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	0990	Debriefing	0990-PSUNC-Tracking Survey-Debriefing Form.doc		No	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

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: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,000	1,000
Annual IC Time Burden (Hours)	400	400
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
0990-PSUNC-TrackingSurvey-Knowledge Networks Panel Recruitment Methodology	0990-PSUNC-TrackingSurvey-Knowledge Networks Panel Recruitment Methodology.doc	04/07/2009
0990-PSUNC-TrackingSurvey-Assurances of Confidentiality and Study Consent	0990-PSUNC-TrackingSurvey-Assurances of Confidentiality and Study Consent.doc	04/07/2009
0990-PSUNC-TrackingSurvey-Knowledge Networks Privacy and Confidentiality Procedures	0990-PSUNC-TrackingSurvey-Knowledge Networks Privacy and Confidentiality Procedures.doc	04/07/2009
IRB	0990-PSUNC-TrackingSurvey-RTI IRB Approval Notice 02-24-09.pdf	04/07/2009

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