OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Focus Groups with Rural Youth to Test Strategic Concepts Designed to Prevent Youth Smokeless Tobacco Use

IC 210333 under ICR 201406-0910-011 · OMB 0910-0674.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Rural Smokeless Strategic Concepts FG_Parental Consent Form.docx Other-Parental Consent Form
Rural Smokeless Strategic Concepts FG_Youth Assent Form.docx Other-Youth Assent
Rural Strategic Concept FG_Concept Ranking Sheet_OMB.PDF Other-Concept Ranking Sheet
Rural Strategic Concept FG_Discussion Guide.docx Other-Discussion Guide
Rural Strategic Concept FG_Homework.docx Other-Homework
Rural Strategic Concept FG_Image Matching Sheet_OMB.PDF Other-Image Matching Sheet
Rural Strategic Concept FG_Participant Rating Sheet_OMB.PDF Other-Participant Rating Sheet
Rural Strategic Concept FGs_Screener.docx Other-Screner Document
Rural Strategic Concept FG_Image Matching Stimuli.pdf Other-Image Matching Stimuli
Rural Strategic Concept FG_Strategic Concept Stimuli.pdf Other-Strategic Concept Stimuli
Rural Strategic Concept FG_OMB Memo_2_7_14.doc
Rural Strategic Concept FG_OMB Memo_2_7_14		IC Document

Information Collection (IC) Details

View Information Collection (IC)

layout table

Information Collection Instruments:
table that charts list of instruments
Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Parental Consent Form Yes Yes Fillable Printable
Other-Youth Assent Yes Yes Fillable Printable
Other-Concept Ranking Sheet Yes Yes Fillable Printable
Other-Discussion Guide Yes Yes Fillable Printable
Other-Homework Yes Yes Fillable Fileable
Other-Image Matching Sheet Yes Yes Fillable Printable
Other-Participant Rating Sheet Yes Yes Fillable Printable
Other-Screner Document Yes Yes Fillable Printable
Other-Image Matching Stimuli Yes Yes Printable Only
Other-Strategic Concept Stimuli Yes Yes Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Requested 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 128 0 0 0 0 128
Annual IC Time Burden (Hours) 256 0 0 0 0 256
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Documents for IC
table that charts IC Documents
Title Document Date Uploaded
Rural Strategic Concept FG_OMB Memo_2_7_14 02/07/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
Something went wrong when downloading this file. If you have any questions, please send an email to [email protected].