Information Collection

Recruitment of Districts

IC 185552 under ICR 201501-0920-019 · OMB 0920-0621.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0621 can be found here:

Documents and Forms

Document Name Document Type
Attachment F1_District-level Recruitment Script for the National Youth Tobacco Survey.doc Instruction
Attachment F2_District Letter of Invitation.docx District Letter of Invitation IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Recruitment of Districts	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			Attachment F1_District-level Recruitment Script for the National Youth Tobacco Survey.doc		Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 150	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	150	150
Annual IC Time Burden (Hours)	75	75
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
District Letter of Invitation	Attachment F2_District Letter of Invitation.docx	12/15/2014

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