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Federal forms, ICRs, and supporting documents

Information Collection

Merchant Interview&Youth Focus Groups Reactions to Tobacco Product Flavor Bans

IC 214940 under ICR 201406-0910-011 · OMB 0910-0674.

Documents and Forms
Document Name
Document Type
Other-Survey
Other-Survey
Other-Questionnaire
Other-Group Guide
Other-Consent Form
Other-Consent Form
Other-Assent Form
Other-Merchant Recruitment Script
Other-Recruitment Script
Other-Youth Recruitment Script
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Merchant Interview&Youth Focus Groups Reactions to Tobacco Product Flavor Bans CTP
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Survey Attachment 2-Chicago Merchant Interview Guide.docx Yes Yes Fillable Printable
Other-Survey Attachment 1-NYC Merchant Interview Guide.docx Yes Yes Fillable Printable
Other-Questionnaire Attachment 3-Chicago Demographic Questionnaire.doc Yes Yes Fillable Printable
Other-Group Guide Attachment 4-Chicago Focus Group Guide.docx Yes Yes Fillable Printable
Other-Consent Form Attachment 5-Chicago Parental Consent.doc Yes Yes Fillable Printable
Other-Consent Form Attachment 6-Chicago Participant Consent.doc Yes Yes Fillable Printable
Other-Assent Form Attachment 7-Chicago Youth Assent.docx Yes Yes Fillable Printable
Other-Merchant Recruitment Script Attachment 8 - Merchant Interview Recruitment Script_2-9-15.docx Yes Yes Fillable Printable
Other-Recruitment Script Attachment 9-NYC Merchant Interviews Recruitment Script.docx Yes Yes Fillable Printable
Other-Youth Recruitment Script Attachment 10-Focus Group Recruitment Script.docx Yes Yes Fillable Printable

Health Consumer Health and Safety

 

945 345
   
Individuals or Households
 
   100 %

  Approved 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 1,100 0 1,100 0 0 0
Annual IC Time Burden (Hours) 193 0 193 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Chicago Youth Recruitment Flyer Chicago Recruitment Flyer.pub 02/10/2015
Merchant Interviews & Youth Focus Group Reactions to Tobacco Flavor Bans NYC-Chicago_FDA_Abbr_Memo_-_Generic_Clearance_0910_0674.docx 02/11/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.