Information Collection

Point-of-Sale Creative Concept Testing – Focus Groups with Current Adult Smokers

IC 220637 under ICR 201411-0910-007 · OMB 0910-0796.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0796 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
POS Creative Concept Testing_Screener.docx	Other-Screener
POS Creative Concept Testing_Consent Form.docx	Other-Consent Form
POS Creative Concept Testing_Participant Rating Worksheet.pdf	Other-Participant Rating Worksheet
POS Creative Concept Testing_Discussion Guide.docx	Other-Discussion Guide
POS_Quit Journey Worksheet.docx	Other-Quit Journey Worksheet
POS Stimuli.pdf	Other-Stimuli
POS Creative Concept Testing_OMB Memo.doc Supporting Statement Memo	IC Document

IC Title:

Point-of-Sale Creative Concept Testing â Focus Groups with Current Adult Smokers

Agency IC Tracking Number:

CTP

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screener	POS Creative Concept Testing_Screener.docx	Yes	No	Fillable Printable
Other-Consent Form	POS Creative Concept Testing_Consent Form.docx	No		Paper Only
Other-Participant Rating Worksheet	POS Creative Concept Testing_Participant Rating Worksheet.pdf	No		Paper Only
Other-Discussion Guide	POS Creative Concept Testing_Discussion Guide.docx	No		Printable Only
Other-Quit Journey Worksheet	POS_Quit Journey Worksheet.docx	No		Printable Only
Other-Stimuli	POS Stimuli.pdf	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 512

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	512	512
Annual IC Time Burden (Hours)	278	278
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement Memo	POS Creative Concept Testing_OMB Memo.doc	03/16/2016

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