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Students 2012 - 2014 National Youth Tobacco Surveys
2012 - 2014 National Youth Tobacco Survey (NYTS)
OMB: 0920-0621
IC ID: 185555
OMB.report
HHS/CDC
OMB 0920-0621
ICR 201309-0920-012
IC 185555
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0621 can be found here:
2024-01-19 - Revision of a currently approved collection
2022-04-06 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment I-7. Questionnaire Administration Guide_12 20 2011.doc
Other-Word
National Youth Tobacco Survey 2014
Attachment I-1, 2014 NYTS Instrument 2013.09.16.docx
Form
Attachment I-2. Parental Permission Form Distribution Script - 06 08 2011.doc
Attachment I-2
IC Document
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
Other-Word
Attachment I-7. Questionnaire Administration Guide_12 20 2011.doc
Yes
Yes
Fillable Printable
Form
None
National Youth Tobacco Survey 2014
Attachment I-1, 2014 NYTS Instrument 2013.09.16.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
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 %
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
24,591
0
0
0
0
24,591
Annual IC Time Burden (Hours)
18,443
0
0
0
0
18,443
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment I-2
Attachment I-2. Parental Permission Form Distribution Script - 06 08 2011.doc
09/15/2011
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.