Information Collection

Bring Your Brave Campaign Message Testing

IC 225789 under ICR 201502-0920-001 · OMB 0920-0572.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0572 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Bring Your Brave Campaign Message Testing	Form
Bring Your Brave Campaign Testing Survey Attachment_B_Online_Survey_3.15.17 (003).docx	Form
HMTS_Expedited_Review_Form_1.5.17.docx Request for Approval	IC Document
Attachment_C_Materials_for_testing.pptx Materials for Testing	IC Document
Attachment_D_684_Form.pdf Non-research Determination	IC Document
Attachment_A_Protocol_Summary_3.15.17.docx Protocol Summary	IC Document

IC Title:

Bring Your Brave Campaign Message Testing

Agency IC Tracking Number:

17TN

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	Bring Your Brave Campaign Testing Survey	Attachment_B_Online_Survey_3.15.17 (003).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	67	67
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Request for Approval	HMTS_Expedited_Review_Form_1.5.17.docx	03/13/2017
Materials for Testing	Attachment_C_Materials_for_testing.pptx	03/13/2017
Non-research Determination	Attachment_D_684_Form.pdf	03/13/2017
Protocol Summary	Attachment_A_Protocol_Summary_3.15.17.docx	03/16/2017

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