National Adult Tobacco Survey - Landline

National Adult Tobacco Survey

Documents and Forms

Document Name Document Type
National Adult Tobacco Survey - Landline Form and Instruction
Survey - English H-3. NATS 2013-2014 Questionnaire-8-29-2013-English.docx Form and Instruction
Survey - Spanish I-3. NATS 2013-2014 Questionnaire-8-29-2013-Spanish.docx Form and Instruction

Information Collection (IC) Details

IC Title:	National Adult Tobacco Survey - Landline	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	Survey - English	H-3. NATS 2013-2014 Questionnaire-8-29-2013-English.docx		Yes	No	Fillable Printable
Form and Instruction	none	Survey - Spanish	I-3. NATS 2013-2014 Questionnaire-8-29-2013-Spanish.docx		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 56,250	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	56,250	56,250
Annual IC Time Burden (Hours)	18,750	18,750
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.