Underage Drinking Prevention National Media Campaign

Pretesting of Substance Abuse Prevention and Treatment and Mental Health Services Communications Messages

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Form APPENDIX 1 Underage Drinking Prevention National Media Campaign Form and Instruction
APPENDIX 1 QUANTITATIVE PRE-LAUNCH PRE-TEST Appendix_1_Quantitative_Pre-launch_Pre-test_4-20-12[1].docx Form and Instruction
APPENDIX 2 FORCED EXPOSURE BASELINE SURVEY Appendix_2_Forced_Exposure_Baseline_4-20-12[1].docx Form and Instruction
APPENDIX 3 FORCED EXPOSURE FOLLOW-UP SURVEY Appendix_3_Forced_Exposure_Follow-up_4-20-12[1].docx Form and Instruction
APPENDIX 4 NATURAL EXPOSURE BASELINE SURVEY Appendix_4_Natural_Exposure_Baseline_4-20-12[1].docx Form and Instruction
APPENDIX 5 NATURAL EXPOSURE FOLLOW-UP SURVEY Appendix_5_Natural_Exposure_Follow-up__4-20-12[1].docx Form and Instruction
OMB Supporting Statement 4-24-12.docx Supporting Statement IC Document
Appendix 6 Creative Materials.pdf Appendix 6 Creative Materials. IC Document
Appendix 7 Campaign Materials Testing Plan 4-20-12.docx Appendix 7 Campaign Materials Testing Plan IC Document

Information Collection (IC) Details

IC Title:	Underage Drinking Prevention National Media Campaign	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	APPENDIX 1	QUANTITATIVE PRE-LAUNCH PRE-TEST	Appendix_1_Quantitative_Pre-launch_Pre-test_4-20-12[1].docx	Yes	Yes	Fillable Fileable
Form and Instruction	APPENDIX 2	FORCED EXPOSURE BASELINE SURVEY	Appendix_2_Forced_Exposure_Baseline_4-20-12[1].docx	Yes	Yes	Fillable Fileable
Form and Instruction	APPENDIX 3	FORCED EXPOSURE FOLLOW-UP SURVEY	Appendix_3_Forced_Exposure_Follow-up_4-20-12[1].docx	Yes	Yes	Fillable Fileable
Form and Instruction	APPENDIX 4	NATURAL EXPOSURE BASELINE SURVEY	Appendix_4_Natural_Exposure_Baseline_4-20-12[1].docx	Yes	Yes	Fillable Fileable
Form and Instruction	APPENDIX 5	NATURAL EXPOSURE FOLLOW-UP SURVEY	Appendix_5_Natural_Exposure_Follow-up__4-20-12[1].docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,250	6,250
Annual IC Time Burden (Hours)	1,808	1,808
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement	OMB Supporting Statement 4-24-12.docx	04/25/2012
Appendix 6 Creative Materials.	Appendix 6 Creative Materials.pdf	04/25/2012
Appendix 7 Campaign Materials Testing Plan	Appendix 7 Campaign Materials Testing Plan 4-20-12.docx	04/25/2012

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