Information Collection

National Adult Tobacco Survey - Cell Phone

IC 202260 under ICR 201309-0920-003 · OMB 0920-0828.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
National Adult Tobacco Survey - Cell Phone	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

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

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
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: 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	Previously Approved
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.