Smoker Follow-up Survey Wave 4

Evaluation of the National Tobacco Prevention and Control Public Education Campaign

OMB: 0920-0923

IC ID: 210359

Information Collection (IC) Details

View Information Collection (IC)

Smoker Follow-up Survey Wave 4
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Smoker Follow-up Survey (Waves 2-5) Screenshots C-3 Smoker Follow-Up Survey (Waves 2-5) Screenshots_9 04 2014.pdf Yes Yes Fillable Fileable
Form none Spanish Smoker Follow-up Survey (Waves 2-5) C-3 Smoker Follow-Up Survey (Waves 2-5)_SPANISH_9 04 2014.docx Yes Yes Fillable Fileable

Health Immunization Management

 

1,982 0
   
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 1,982 0 0 0 0 1,982
Annual IC Time Burden (Hours) 991 0 0 0 0 991
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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

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