OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

LGBT Young Adult Tobacco Use Prevention Campaign: Copy Testing

IC 218027 under ICR 201406-0910-011 · OMB 0910-0674.

Documents and Forms
Document Name
Document Type
Other-Consent
Other-Electronic Screener
Other-Paper Screener
Other-Questionnaire
Other-Stimuli
IC Document
Information Collection (IC) Details

View Information Collection (IC)

LGBT Young Adult Tobacco Use Prevention Campaign: Copy Testing CTP
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Consent LGBT Copy Consent.docx Yes Yes Fillable Fileable
Other-Electronic Screener LGBT Copy Electronic Screener.docx Yes Yes Fillable Fileable
Other-Paper Screener LGBT Copy Paper Screener.pdf No   Printable Only
Other-Questionnaire LGBT Copy Questionnaire.docx Yes Yes Fillable Fileable
Other-Stimuli LGBT Copy Stimuli.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

11,500 0
   
Individuals or Households
 
   0 %

  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 11,500 0 11,500 0 0 0
Annual IC Time Burden (Hours) 1,278 0 1,278 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Memo - Supporting Statement OMB Justification Memo_LGBT.docx 08/26/2015
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.