Information Collection

OSH Rough Cut Testing of TV Ads Main Questionnaire

IC 200753 under ICR 201201-0920-005 · OMB 0920-0901.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 2. OSH Rough Cut Testing of TV Ads-Main Questionnaire-1.6.12.doc	Instruction
New Harris Poll Online Survey.mht Attachment 6 New Harris Poll Online Survey	IC Document
Reminder This Harris Poll Online Survey Is Still Open.mht Attachment 7 Reminder This Harris Poll Online Survey Is Still Open	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

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
Instruction			Attachment 2. OSH Rough Cut Testing of TV Ads-Main Questionnaire-1.6.12.doc		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,600

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	1,600	1,600
Annual IC Time Burden (Hours)	187	187
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Attachment 6 New Harris Poll Online Survey	New Harris Poll Online Survey.mht	01/11/2012
Attachment 7 Reminder This Harris Poll Online Survey Is Still Open	Reminder This Harris Poll Online Survey Is Still Open.mht	01/11/2012

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