Information Collection

Interviews with Tobacco Retailers to Inform Retailer Education

IC 206333 under ICR 201406-0910-011 · OMB 0910-0674.

Documents and Forms

Document Name Document Type
Appendix B2_Recruitment Materials.pdf Other-Appendix B2 Manager Recruitmen
Appendix B1_Recruitment Materials.pdf Other-Appendix B1 Clerk Recruitment
Appendix C_Clerk Screener.pdf Other-Appendix C Store Clerk Recruit
Appendix D_Manager Screener.pdf Other-Appendix D Manager Recruitment
Appendix E_Clerk Interview Guide.pdf Other-Appendix E Clerk Interview Gui
Appendix F_Manager Interview Guide.pdf Other-Appendix F Manager Interview G
Appendix A_Information about Mental Models.pdf Appendix A_Information about Mental Models IC Document
OMB Justification Memo.pdf OMB Justification Memo IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Interviews with Tobacco Retailers to Inform Retailer Education	Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Appendix B2 Manager Recruitment Materials	Appendix B2_Recruitment Materials.pdf	Yes	No	Printable Only
Other-Appendix B1 Clerk Recruitment Materials	Appendix B1_Recruitment Materials.pdf	Yes	No	Printable Only
Other-Appendix C Store Clerk Recruitment Follow Up Telephone Screening	Appendix C_Clerk Screener.pdf	Yes	No	Printable Only
Other-Appendix D Manager Recruitment Matl: Telephone Screening	Appendix D_Manager Screener.pdf	Yes	No	Printable Only
Other-Appendix E Clerk Interview Guide	Appendix E_Clerk Interview Guide.pdf	Yes	No	Printable Only
Other-Appendix F Manager Interview Guide	Appendix F_Manager Interview Guide.pdf	Yes	No	Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 90	Number of Respondents for Small Entity: 90

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 67 %

	Requested	Previously Approved
Annual Number of Responses for this IC	90	90
Annual IC Time Burden (Hours)	82	82
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Appendix A_Information about Mental Models	Appendix A_Information about Mental Models.pdf	03/28/2013
OMB Justification Memo	OMB Justification Memo.pdf	04/02/2013

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