Copy Testing of Television and Print Ads

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⚠️ Notice: This information collection may be referencing outdated material.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
Copy Testing of Television and Print Ads Form
Screener Att 1a - Survey Screener Subpopulation v20.doc Form
Survey Att 1b - Survey Main Subpopulations v20.docx Form
Survey Screenshots Att 5_Screenshots v6 0 IC#12.pdf Form
Part A_GenIC 12_Copy test v24 08112014.docx SS Part A IC Document
Part B_GenIC 12_Copy test v23 08112014 docx.docx Part B IC Document
Att 3_Privacy Policy v4.0 06052014.docx Toluna Privacy Policy IC Document
Att 4_Terms and Conditions v4.0 06052014.docx Toluna Terms IC Document
Att 2_Email Recruitment v4.0 06052014.docx Email Recruitment IC Document

Information Collection (IC) Details

IC Title:	Copy Testing of Television and Print Ads	Agency IC Tracking Number:	14AUL

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 Subpopulation v20.doc	Yes	Yes	Fillable Fileable
Form	none	Survey	Att 1b - Survey Main Subpopulations v20.docx	Yes	Yes	Fillable Fileable
Form	none	Survey Screenshots	Att 5_Screenshots v6 0 IC#12.pdf	Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 3,600	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	3,600	3,600
Annual IC Time Burden (Hours)	1,180	1,180
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
SS Part A	Part A_GenIC 12_Copy test v24 08112014.docx	08/13/2014
Part B	Part B_GenIC 12_Copy test v23 08112014 docx.docx	08/13/2014
Toluna Privacy Policy	Att 3_Privacy Policy v4.0 06052014.docx	08/13/2014
Toluna Terms	Att 4_Terms and Conditions v4.0 06052014.docx	08/13/2014
Email Recruitment	Att 2_Email Recruitment v4.0 06052014.docx	08/13/2014

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