Information Collection Request

May 2011 Questionnaire for Tobacco Use Supplements to the Current Population Survey (TUS-CPS) (NCI)

ICR 201102-0925-007 · OMB 0925-0368 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 3 Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS) Form and Instruction Modified Available
Form 1 2011 Follow-Up Questionnaire (TUS-CPS) Form and Instruction Modified Available
TUS-CPS May 2011 Follow Up Q _AH finl2_OMB_PB_3-3_11.doc Supplementary Document Uploaded 2011-03-10 Available
Pass back Request Memo_TUS-CPS.doc Supplementary Document Uploaded 2011-03-10 Available
Change Request Memo_TUS-CPS_AH 1-20-11.doc Justification for No Material/Nonsubstantive Change Uploaded 2011-02-01 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
7287 Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS) Form and Instruction Modified
191981 2011 Follow-Up Questionnaire (TUS-CPS) Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2013 03/31/2013 03/31/2013
105,000 0 105,000
15,000 0 15,000
0 0 0





Reginfo record details
2
table that charts list of burden
IC Title Form No. Form Name
2011 Follow-Up Questionnaire (TUS-CPS) 1, 2 May 2011 Follow Up Q ,   TUS-CPS May 2011 Questionnaire Final
Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS) 3, 2 TUS-CPS Q Spanish ,   TUS-CPS Q

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 105,000 105,000 0 0 0 0
Annual Time Burden (Hours) 15,000 15,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No