Information Collection

Online Quantitative Study of Youth Reactions to Rough-Cut Advertising Designed to Prevent Youth Tobacco Use

IC 208858 under ICR 201406-0910-011 · OMB 0910-0674.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Experimenter Copy Testing Stimuli_OMB Submission_9_10_11.pptx	Other-Stimuli
Experimenter Copy Testing_Screener.docx	Other-Screener
Experimenter_Copy_Testing_ Youth Assent.docx	Other-Youth Assent
Experimenter_Copy_Testing_ Parent Consent.docx	Other-Parent Consent
Tobacco Copy Testing Questionnaire.docx	Other-QUESTIONNAIRE
Experimenter_Copy_Testing OMB Justification Memo.docx OMB Justification Memo	IC Document

IC Title:

Agency IC Tracking Number:

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Stimuli	Experimenter Copy Testing Stimuli_OMB Submission_9_10_11.pptx	Yes	Yes	Fillable Printable
Other-Screener	Experimenter Copy Testing_Screener.docx	Yes	Yes	Fillable Fileable
Other-Youth Assent	Experimenter_Copy_Testing_ Youth Assent.docx	Yes	Yes	Fillable Fileable
Other-Parent Consent	Experimenter_Copy_Testing_ Parent Consent.docx	Yes	Yes	Fillable Fileable
Other-QUESTIONNAIRE	Tobacco Copy Testing Questionnaire.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,575

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,575	1,575
Annual IC Time Burden (Hours)	528	528
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Justification Memo	Experimenter_Copy_Testing OMB Justification Memo.docx	09/27/2013

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