Information Collection

Assessment of the 2014 Best Practices Guide for Comprehensive Tobacco Control Programs

IC 227173 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⚠️ Notice: This information collection may be referencing outdated material.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 the 2014 Best Practices Guide for Comprehensive Tobacco Control Programs	Form and Instruction
Best Practices Evaluation: Telephone Interview Guide Attachment A- Telephone Interview Guide.docx	Form and Instruction
Attachment B- Invitation Email.docx Invitation Email	IC Document
Attachment C- Confirmation Email.docx Confirmation Email	IC Document
Attachment D- Reminder Email.docx Reminder Email	IC Document
Attachment E- Follow Up Email.docx Follow-Up Email	IC Document
BP-EVAL-SSA_Revised.docx Supporting Statement A	IC Document
BP-EVAL-SSB.docx Supporting Statement B	IC Document

IC Title:

Assessment of the 2014 Best Practices Guide for Comprehensive Tobacco Control Programs

Agency IC Tracking Number:

0920-0879-17APP

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	NA	Best Practices Evaluation: Telephone Interview Guide	Attachment A- Telephone Interview Guide.docx	NA	No		Paper Only

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)	60	60
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Invitation Email	Attachment B- Invitation Email.docx	06/13/2017
Confirmation Email	Attachment C- Confirmation Email.docx	06/13/2017
Reminder Email	Attachment D- Reminder Email.docx	06/13/2017
Follow-Up Email	Attachment E- Follow Up Email.docx	06/13/2017
Supporting Statement A	BP-EVAL-SSA_Revised.docx	06/13/2017
Supporting Statement B	BP-EVAL-SSB.docx	06/13/2017

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