Information Collection

Consumer perceptions as a foundation for CTP positioning initiative

IC 201564 under ICR 201103-0910-003 · OMB 0910-0497.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0497 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
CTP Positioning DOC 03_Adolescent Screener.doc	Other-Adolescent Screener
CTP Positioning DOC 04_Adult Screener.doc	Other-Adult Screener
CTP Positioning DOC 05_Adolescent Assent Form.doc	Other-Adolescent Assent Form
CTP Positioning DOC 06_Adult Informed Consent.doc	Other-Adult Informed Consent
CTP Positioning DOC 01_Generic Clearance Memorandum.doc OMB Justification Memo	IC Document
CTP Positioning DOC 02_Focus Group Composition.doc CTP Positioning DOC 02_Focus Group Composition	IC Document
CTP Positioning DOC 07_Adolescent Moderators Guide.doc CTP Positioning DOC 07_Adolescent Moderators Guide	IC Document
CTP Positioning DOC 08_Adult Moderators Guide.doc CTP Positioning DOC 08_Adult Moderators Guide	IC Document
CTP Positioning DOC 09_CTP Description.doc CTP Positioning DOC 09_CTP Description	IC Document
CTP Positioning DOC 10_Territory Stimuli.pptx CTP Positioning DOC 10_Territory Stimuli	IC Document
CTP Positioning DOC 11_Interbrand Nondisclosure Agreement.pdf CTP Positioning DOC 11_Interbrand Nondisclosure Agreement	IC Document

IC Title:

Consumer perceptions as a foundation for CTP positioning initiative

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Adolescent Screener	Yes	No	Paper Only
Other-Adult Screener	Yes	No	Paper Only
Other-Adolescent Assent Form	Yes	No	Paper Only
Other-Adult Informed Consent	Yes	No	Paper Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 64

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	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	64	0	0	0	0	0
Annual IC Time Burden (Hours)	128	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Justification Memo		03/14/2012
CTP Positioning DOC 02_Focus Group Composition		03/14/2012
CTP Positioning DOC 07_Adolescent Moderators Guide		03/14/2012
CTP Positioning DOC 08_Adult Moderators Guide		03/14/2012
CTP Positioning DOC 09_CTP Description		03/14/2012
CTP Positioning DOC 10_Territory Stimuli		03/14/2012
CTP Positioning DOC 11_Interbrand Nondisclosure Agreement		03/14/2012

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

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