Rural Smokeless Creative Concept Testing – Focus Groups with Rural Youth

Pretesting of Tobacco Communications

Documents and Forms

Document Name Document Type
Appendix A- Rural Smokeless Creative FG_Screener.docx Instruction
Appendix B- Rural Creative FG_Discussion Guide.docx Instruction
Appendix C- Rural Creative FG_Participant Rating Worksheet.pdf Instruction
Appendix D- Rural Creative FG_Creative Concept &Brand Stimuli.docx Instruction
Appendix E- Rural Creative FG_Parental Consent Form.docx Instruction
Appendix F- Rural Creative FG_Parental Notification Form.docx Instruction
Appendix G- Rural Creative FG_Youth Assent Form.docx Instruction
Rural Smokeless Creative Concepts OMB Justification Memo.docx OMB Justification Memo IC Document

Information Collection (IC) Details

IC Title:	Rural Smokeless Creative Concept Testing – Focus Groups with Rural Youth	Agency IC Tracking Number:	CTP

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	Appendix A- Rural Smokeless Creative FG_Screener.docx	Yes	No	Printable Only
Instruction	Appendix B- Rural Creative FG_Discussion Guide.docx	Yes	No	Printable Only
Instruction	Appendix C- Rural Creative FG_Participant Rating Worksheet.pdf	Yes	No	Printable Only
Instruction	Appendix D- Rural Creative FG_Creative Concept &Brand Stimuli.docx	Yes	No	Printable Only
Instruction	Appendix E- Rural Creative FG_Parental Consent Form.docx	Yes	No	Printable Only
Instruction	Appendix F- Rural Creative FG_Parental Notification Form.docx	Yes	No	Printable Only
Instruction	Appendix G- Rural Creative FG_Youth Assent Form.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 576	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	576	576
Annual IC Time Burden (Hours)	384	384
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Justification Memo	Rural Smokeless Creative Concepts OMB Justification Memo.docx	08/07/2014

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