CopyTesting of Television Advertising

Testing and Evaluation of Tobacco Communication Activities

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0910 can be found here:

Documents and Forms

Document Name Document Type
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

Information Collection (IC) Details

IC Title:	CopyTesting of Television Advertising	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection 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 %

	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

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.