Information Collection

The Real Cost General Market: Wave 4 Creative Concept Testing Designed to Prevent Youth ENDS Use

IC 229054 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⚠️ Notice: This information collection may be referencing outdated material.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
Concept Ranking Sheet.docx	Other-Concept Ranking Sheet
Concept Rating Sheet.docx	Other-Concept Ranking Sheet 2
Discussion Guide-Final.doc	Other-Discussion Guide-Final
ENDS stimuli.docx	Other-ENDS stimuli
Parental Permission Form.docx	Other-Parental Permission Form
Screener.docx	Other-Screener
Youth Assent Form.docx	Other-Youth Assent Form
OMB Memo General Market Youth Tobacco Wave 4.docx OMB Memo	IC Document
FDA_IRB Letter.docx FDA_IRB Letter	IC Document

IC Title:

The Real Cost General Market: Wave 4 Creative Concept Testing Designed to Prevent Youth ENDS Use

Agency IC Tracking Number:

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-Parental Permission Form	Parental Permission Form.docx	No		Paper Only
Other-Screener	Screener.docx	Yes	Yes	Fillable Fileable Signable
Other-Youth Assent Form	Youth Assent Form.docx	No		Paper Only
Other-Concept Ranking Sheet	Concept Ranking Sheet.docx	No		Paper Only
Other-Concept Ranking Sheet 2	Concept Rating Sheet.docx	No		Paper Only
Other-Discussion Guide-Final	Discussion Guide-Final.doc	No		Paper Only
Other-ENDS stimuli	ENDS stimuli.docx	No		Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,152

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	1,152	1,152
Annual IC Time Burden (Hours)	387	387
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OMB Memo	OMB Memo General Market Youth Tobacco Wave 4.docx	11/15/2017
FDA_IRB Letter	FDA_IRB Letter.docx	11/15/2017

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