Information Collection

Interviews with Tobacco Retailers to Inform Retailer Education

IC 206333 under ICR 201301-0910-006 · OMB 0910-0674.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0674 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix B2_Recruitment Materials.pdf	Other-Appendix B2 Manager Recruitmen
Appendix B1_Recruitment Materials.pdf	Other-Appendix B1 Clerk Recruitment
Appendix C_Clerk Screener.pdf	Other-Appendix C Store Clerk Recruit
Appendix D_Manager Screener.pdf	Other-Appendix D Manager Recruitment
Appendix E_Clerk Interview Guide.pdf	Other-Appendix E Clerk Interview Gui
Appendix F_Manager Interview Guide.pdf	Other-Appendix F Manager Interview G
Appendix A_Information about Mental Models.pdf Appendix A_Information about Mental Models	IC Document
OMB Justification Memo.pdf OMB Justification Memo	IC Document

IC Title:

Interviews with Tobacco Retailers to Inform Retailer Education

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix B2 Manager Recruitment Materials	Appendix B2_Recruitment Materials.pdf	Yes	No	Printable Only
Other-Appendix B1 Clerk Recruitment Materials	Appendix B1_Recruitment Materials.pdf	Yes	No	Printable Only
Other-Appendix C Store Clerk Recruitment Follow Up Telephone Screening	Appendix C_Clerk Screener.pdf	Yes	No	Printable Only
Other-Appendix D Manager Recruitment Matl: Telephone Screening	Appendix D_Manager Screener.pdf	Yes	No	Printable Only
Other-Appendix E Clerk Interview Guide	Appendix E_Clerk Interview Guide.pdf	Yes	No	Printable Only
Other-Appendix F Manager Interview Guide	Appendix F_Manager Interview Guide.pdf	Yes	No	Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 90

Number of Respondents for Small Entity: 90

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 67 %

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	90	0	0	0	0	0
Annual IC Time Burden (Hours)	82	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
Appendix A_Information about Mental Models	Appendix A_Information about Mental Models.pdf	03/28/2013
OMB Justification Memo	OMB Justification Memo.pdf	04/02/2013

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