Experimental Survey

Experimental Study on the Public Display of Lists of Harmful and Potential Harmful Tobacco Constituents

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0736 can be found here:

Documents and Forms

Document Name Document Type
Appendix B-Stimuli.pdf Other-Appendix B - Stimuli
HPHC_Prototype1Cigarette22.pdf Other-HPHC Prototype 1 Cigarette 22
HPHC_Prototype1RollYourOwn10.pdf Other-HPHC Prototype 1 Roll Your Own
HPHC_Prototype2Cigarette22.pdf Other-HPHC Prototype 2 Cigarette 22
HPHC_Prototype2RollYourOwn02.pdf Other-HPHC Prototype 2 Roll Your Own
HPHC_Prototype3Cigarette22.pdf Other-HPHC Prototype 3 Cigarette 22
HPHC_Prototype3RollYourOwn02.pdf Other-HPHC Prototype 3 Rool Your Own
HPHC_Prototype4CigaretteNoGraphs05.pdf Other-HPHC Prototype 4 Cigarette No
HPHC_Prototype4RollYourOwn10.pdf Other-HPHC Prototype 4 Roll Your Own
HPHC_Prototype5Cigarette3.pdf Other-HPHC Prototype 5 Cigarette 3
HPHC_Prototype5RollYourOwn02.pdf Other-HPHC Prototype 5 Roll Your Own
HPHC_Prototype6Cigarette2.pdf Other-HPHC Prototype 6 Cigarette 2
HPHC_Prototype6RollYourOwn02.pdf Other-HPHC Prototype 6 Roll Your Own

Information Collection (IC) Details

IC Title:	Experimental Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix B - Stimuli	Appendix B-Stimuli.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 1 Cigarette 22	HPHC_Prototype1Cigarette22.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 1 Roll Your Own 10	HPHC_Prototype1RollYourOwn10.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 2 Cigarette 22	HPHC_Prototype2Cigarette22.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 2 Roll Your Own 02	HPHC_Prototype2RollYourOwn02.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 3 Cigarette 22	HPHC_Prototype3Cigarette22.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 3 Rool Your Own 02	HPHC_Prototype3RollYourOwn02.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 4 Cigarette No Graphs 05	HPHC_Prototype4CigaretteNoGraphs05.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 4 Roll Your Own 10	HPHC_Prototype4RollYourOwn10.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 5 Cigarette 3	HPHC_Prototype5Cigarette3.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 5 Roll Your Own 2	HPHC_Prototype5RollYourOwn02.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 6 Cigarette 2	HPHC_Prototype6Cigarette2.pdf	Yes	Yes	Printable Only
Other-HPHC Prototype 6 Roll Your Own 02	HPHC_Prototype6RollYourOwn02.pdf	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,150	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,150	3,150
Annual IC Time Burden (Hours)	1,575	1,575
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.