Information Collection

Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems

IC 219063 under ICR 201412-0920-008 · OMB 0920-0910.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0910 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Screener Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems	Form
Moderator's Guide Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems	Form
Screener Att 1-Screener 11 23 15.doc	Form
Moderator's Guide Att 4-Moderator's Guide 11 20 15.docx	Form
0920-0910_Part A_OSH ENDS Focus Groups 11 20 15.docx SS Part A	IC Document
0920-0910_Part B_OSH ENDS Focus Groups 11 20 15.docx SS Part B	IC Document
Att 2-Informed Consent doc 11 20 15.doc Informed Consent	IC Document
Att 3 ICF Institutional Review Board Approval.pdf IRB	IC Document
Attachment 5 ENDS and 2014 SGR Fact Sheet OSH ENDS Focus Groups_lje.pdf Fact Sheet	IC Document
Att 6-Confirmation Script docx 11 20 15.docx Confirmation Script	IC Document
Att 7- Smoker Cessation Material Fact Sheet.pdf Material Fact Sheet	IC Document

IC Title:

Parents' Perceptions of Public Service Announcement Concepts on Electronic Nicotine Delivery Systems

Agency IC Tracking Number:

16FS

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	Screener	Att 1-Screener 11 23 15.doc		No		Paper Only
Form	none	Moderator's Guide	Att 4-Moderator's Guide 11 20 15.docx		No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 270

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	270	270
Annual IC Time Burden (Hours)	150	150
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SS Part A	0920-0910_Part A_OSH ENDS Focus Groups 11 20 15.docx	11/24/2015
SS Part B	0920-0910_Part B_OSH ENDS Focus Groups 11 20 15.docx	11/24/2015
Informed Consent	Att 2-Informed Consent doc 11 20 15.doc	11/24/2015
IRB	Att 3 ICF Institutional Review Board Approval.pdf	11/24/2015
Fact Sheet	Attachment 5 ENDS and 2014 SGR Fact Sheet OSH ENDS Focus Groups_lje.pdf	11/24/2015
Confirmation Script	Att 6-Confirmation Script docx 11 20 15.docx	11/24/2015
Material Fact Sheet	Att 7- Smoker Cessation Material Fact Sheet.pdf	11/24/2015

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