Message Platform Testing for Regular Cigarettes and Dual Use

Message Testing for Tobacco Communication Activities

⚠️ Notice: This information collection may be referencing outdated material.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

Documents and Forms

Document Name Document Type
Att 1A. Screenshots_042016 Screener.pdf Other-Screenshots
Att 1B. Screenshots_05252016 Main.pdf Other-Screenshots
Att 2A Moderator's Guide Dual Use_07 11_2016_OSH_clean.docx Other-WORD
Att 3A Moderator's Guide Cigarette Smokers_07 11_2016_OSH_clean.docx Other-WORD
Part A_Message Platform_07112016_clean.docx Supporting Statement A IC Document
Part B_Message Platform_07 11 2016.docx Supporting Statement B IC Document
Att 4. Email Recruitment_05 13 2016.docx Att 4_Email Recruitment IC Document
Att 5. Terms and Conditions_05 13 2016.docx Att 5_Terms and Conditions IC Document
Att 6. Privacy Policy_05 13 2016.docx Att 6_Privacy Policy IC Document
Att 7. IRB Approval Notice_V1 04 26 2016.pdf Att 7_IRB Approval IC Document

Information Collection (IC) Details

IC Title:	Message Platform Testing for Regular Cigarettes and Dual Use	Agency IC Tracking Number:	16AVE

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Screenshots	Att 1A. Screenshots_042016 Screener.pdf	Yes	Yes	Fillable Fileable
Other-Screenshots	Att 1B. Screenshots_05252016 Main.pdf	Yes	Yes	Fillable Fileable
Other-WORD	Att 2A Moderator's Guide Dual Use_07 11_2016_OSH_clean.docx	No		Paper Only
Other-WORD	Att 3A Moderator's Guide Cigarette Smokers_07 11_2016_OSH_clean.docx	No		Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 16,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	16,000	16,000
Annual IC Time Burden (Hours)	3,146	3,146
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Supporting Statement A	Part A_Message Platform_07112016_clean.docx	07/13/2016
Supporting Statement B	Part B_Message Platform_07 11 2016.docx	07/13/2016
Att 4_Email Recruitment	Att 4. Email Recruitment_05 13 2016.docx	07/13/2016
Att 5_Terms and Conditions	Att 5. Terms and Conditions_05 13 2016.docx	07/13/2016
Att 6_Privacy Policy	Att 6. Privacy Policy_05 13 2016.docx	07/13/2016
Att 7_IRB Approval	Att 7. IRB Approval Notice_V1 04 26 2016.pdf	07/13/2016

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