Information Collection

Assessment of Tobacco Control Program (TCP) Infrastructure

IC 216739 under ICR 201412-0920-011 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Assessment of Tobacco Control Program (TCP) Infrastructure	Form and Instruction
CMI Measurement Tool Att. A Interview Guide.docx	Form and Instruction
TCP-CMI-SSA REVISED.docx TCP-CMI SSA	IC Document
Att. B Introductory Email.docx Introductory Email	IC Document
Att. C_Email and Telephone Reminders.docx Email and Telephone Reminder	IC Document
Att. D Follow up email.docx Follow Up Email	IC Document
TCP-CMI-SSB REVISED.docx TCP-CMI SSB	IC Document

IC Title:

Assessment of Tobacco Control Program (TCP) Infrastructure

Agency IC Tracking Number:

15AMD

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 and Instruction	None	CMI Measurement Tool	Att. A Interview Guide.docx	None	No		Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 51

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	51	51
Annual IC Time Burden (Hours)	77	77
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
TCP-CMI SSA	TCP-CMI-SSA REVISED.docx	05/28/2015
Introductory Email	Att. B Introductory Email.docx	05/28/2015
Email and Telephone Reminder	Att. C_Email and Telephone Reminders.docx	05/28/2015
Follow Up Email	Att. D Follow up email.docx	05/28/2015
TCP-CMI SSB	TCP-CMI-SSB REVISED.docx	05/28/2015

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