Information Collection

National Tobacco Prevention and Control Public Education Campaign: Rough Cut Testing of TV Ads

IC 200757 under ICR 201306-0920-004 · OMB 0920-0910.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0910 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 1. OSH Rough Cut Testing of TV Ads-Screener-1.6.12.doc	Instruction
Attachment 2. OSH Rough Cut Testing of TV Ads-Main Questionnaire-1.6.12.doc	Instruction
0920-0910_IC #1TV Rough Cuts 09 2012.docx 0920-0910_IC #1TV Rough Cuts 09 2012	IC Document
Attachment 4 HIPoints Terms of Use.pdf Attachment 4 HIPoints Terms of Use	IC Document
Attachment 3 HIPoints Terms Conditions.pdf Attachment 3 HIPoints Terms Conditions	IC Document
Attachment 5 HIPoints Privacy Policy.pdf Attachment 5 HIPoints Privacy Policy	IC Document
New Harris Poll Online Survey.mht New Harris Poll Online Survey	IC Document
New Harris Poll Online Survey.mht New Harris Poll Online Survey	IC Document

IC Title:

National Tobacco Prevention and Control Public Education Campaign: Rough Cut Testing of TV Ads

Agency IC Tracking Number:

IC Status: Modified

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 1. OSH Rough Cut Testing of TV Ads-Screener-1.6.12.doc		Yes	Yes	Printable Only
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: 4,268

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	4,268	4,268
Annual IC Time Burden (Hours)	277	277
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0920-0910_IC #1TV Rough Cuts 09 2012	0920-0910_IC #1TV Rough Cuts 09 2012.docx	01/12/2012
Attachment 4 HIPoints Terms of Use	Attachment 4 HIPoints Terms of Use.pdf	01/12/2012
Attachment 3 HIPoints Terms Conditions	Attachment 3 HIPoints Terms Conditions.pdf	01/12/2012
Attachment 5 HIPoints Privacy Policy	Attachment 5 HIPoints Privacy Policy.pdf	01/12/2012
New Harris Poll Online Survey	New Harris Poll Online Survey.mht	01/12/2012
New Harris Poll Online Survey	New Harris Poll Online Survey.mht	01/12/2012

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