Information Collection

CopyTesting of Television Advertising

IC 210356 under ICR 201312-0920-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Screener CopyTesting of Television Advertising	Form
Main Questionnaire CopyTesting of Television Advertising	Form
Screenshots CopyTesting of Television Advertising	Form
Screener Att 1a. Survey Screener Tips3 Subpop 1 Study 01292014.doc	Form
Main Questionnaire Att 1b. Survey Main Tips3 Subpop 1 01292014.doc	Form
Screenshots Att 5. FramedScreenshots - Dual Use Screener and Main.pdf	Form
Att 2. Email Recruit Tips3 Subpop 1 Study.DOCX Email Invitation	IC Document
Att 3. Privacy Policy Tips3 Subpop 1 Study.DOCX Toluna Privacy Policy	IC Document
Att 4. Terms and Conditions Tips3 Subpop 1 Study.DOCX Toluna Panel Terms and Conditions	IC Document
Part A_Dual Use Tips3 Subpop 1 Study 02102014.docx Supporting Statement A	IC Document
Part B_Dual Use Tips3 Subpop 1 Study 02102014.docx Supporting Statement B	IC Document

IC Title:

CopyTesting of Television Advertising

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Screener	Att 1a. Survey Screener Tips3 Subpop 1 Study 01292014.doc	Yes	Yes	Fillable Fileable
Form	none	Main Questionnaire	Att 1b. Survey Main Tips3 Subpop 1 01292014.doc	Yes	Yes	Fillable Fileable
Form	none	Screenshots	Att 5. FramedScreenshots - Dual Use Screener and Main.pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 3,900

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	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	3,900	0	0	0	0	0
Annual IC Time Burden (Hours)	1,180	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Email Invitation	Att 2. Email Recruit Tips3 Subpop 1 Study.DOCX	02/11/2014
Toluna Privacy Policy	Att 3. Privacy Policy Tips3 Subpop 1 Study.DOCX	02/11/2014
Toluna Panel Terms and Conditions	Att 4. Terms and Conditions Tips3 Subpop 1 Study.DOCX	02/11/2014
Supporting Statement A	Part A_Dual Use Tips3 Subpop 1 Study 02102014.docx	02/11/2014
Supporting Statement B	Part B_Dual Use Tips3 Subpop 1 Study 02102014.docx	02/11/2014

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