Information Collection

National Adult Tobacco Survey - end of cell

IC 202260 under ICR 201205-0920-003 · OMB 0920-0828.

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
H-4 Cover and TOC.docx	Instruction
I-4 Cover and TOC.docx	Instruction

IC Title:

National Adult Tobacco Survey - end of cell

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			H-4 Cover and TOC.docx		Yes	Yes	Fillable Printable
Instruction			I-4 Cover and TOC.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 18,750

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	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	18,750	18,750
Annual IC Time Burden (Hours)	6,250	6,250
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.