Information Collection

Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS)

IC 7287 under ICR 201102-0925-007 · OMB 0925-0368.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0368 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 3 Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS)	Form and Instruction
3 TUS-CPS Q Spanish ATTACHMENT 12 Spanish Translation.pdf	Form and Instruction
2 TUS-CPS Q ATTACHMENT 1_TUS-CPS Q 1-12-10 updt fnl rv4.doc	Form and Instruction

IC Title:

Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS)

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
Form and Instruction	3	TUS-CPS Q Spanish	ATTACHMENT 12 Spanish Translation.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	2	TUS-CPS Q	ATTACHMENT 1_TUS-CPS Q 1-12-10 updt fnl rv4.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90,000

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	90,000	90,000
Annual IC Time Burden (Hours)	13,500	13,500
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

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