Information Collection

Students 2012 - 2014 National Youth Tobacco Surveys

IC 185555 under ICR 201308-0920-013 · OMB 0920-0621.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0621 can be found here:

Documents and Forms

Document Name Document Type
STUDENTS 2012 - 2014 NATIONAL YOUTH TOBACCO SURVEYS Form and Instruction
National Youth Tobacco Survey (NYTS) 2014 Questionnaire Attachment I-1, 2014 NYTS Instrument 2013.08.14.docx Form and Instruction
Attachment I-4. Parental Permission Form and Fact Sheet (Spanish Version) - 06 08 2011.doc Attachment I-4 IC Document
Attachment I-3. Parental Permission Form and Fact Sheet (English version) - 06 08 2011.doc Attachment I-3 IC Document
Attachment I-5. Parental Permission Form Reminder Notice (English version) - 06 08 2011.doc Attachment I-5 IC Document
Attachment I-6. Parental permission form reminder notice (Spanish version) 06 08 2011.doc Attachment I-6 IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	STUDENTS 2012 - 2014 NATIONAL YOUTH TOBACCO SURVEYS	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
Form and Instruction	none	National Youth Tobacco Survey (NYTS) 2014 Questionnaire	Attachment I-1, 2014 NYTS Instrument 2013.08.14.docx		Yes	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24,591	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	24,591	24,591
Annual IC Time Burden (Hours)	18,443	18,443
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment I-4	Attachment I-4. Parental Permission Form and Fact Sheet (Spanish Version) - 06 08 2011.doc	09/15/2011
Attachment I-3	Attachment I-3. Parental Permission Form and Fact Sheet (English version) - 06 08 2011.doc	09/15/2011
Attachment I-5	Attachment I-5. Parental Permission Form Reminder Notice (English version) - 06 08 2011.doc	09/15/2011
Attachment I-6	Attachment I-6. Parental permission form reminder notice (Spanish version) 06 08 2011.doc	09/15/2011

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