National Adult Tobacco Survey Screener

National Adult Tobacco Survey

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0828 can be found here:

Documents and Forms

Document Name Document Type
H-2 Cell Phone Screener.docx Instruction
I-2 Cell Phone Screener.docx Instruction

Information Collection (IC) Details

IC Title:	National Adult Tobacco Survey Screener	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			H-2 Cell Phone Screener.docx		Yes	Yes	Fillable Printable
Instruction			I-2 Cell Phone Screener.docx		Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 41,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	41,000	41,000
Annual IC Time Burden (Hours)	683	683
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.