Information Collection Request

Extended Evaluation of the National Tobacco Prevention and Control Public Education Campaign

ICR 201506-0920-005 · OMB 0920-1083 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Smoker Survey Wave A Form New Available
Nonsmoker Survey Wave D Form New Available
Nonsmoker Survey Wave C Form New Available
Nonsmoker Survey Wave B Form New Available
Nonsmoker Survey Wave A Form New Available
Smoker Survey Wave D Form New Available
Smoker Survey Wave C Form New Available
Smoker Survey Wave B Form New Available
Screening and Consent Questionnaire Form and Instruction New Available
Att J. Source of Respondents for Each Wave of Data Collection_091015.docx Supplementary Document Uploaded 2015-09-10 Available
Att J. Source of Respondents for Each Wave of Data Collection_091015.docx Supplementary Document Uploaded 2015-09-10 Available
Att I-3. ABS Sample Postcard Reminders.docx Supplementary Document Uploaded 2015-06-24 Repair queued
Att I-2. KnowledgePanel Email Invitation and Reminders.doc Supplementary Document Uploaded 2015-06-24 Repair queued
Att I-1. ABS Sample Invitation Letter.docx Supplementary Document Uploaded 2015-06-24 Repair queued
Att H. GfK Privacy and Security Procedures.doc Supplementary Document Uploaded 2015-06-24 Available
Att G. RTI IRB Approval Notice.pdf Supplementary Document Uploaded 2015-06-24 Available
Att F. KnowledgePanel Recruitment Procedures.doc Supplementary Document Uploaded 2015-06-24 Available
Att B. 60-Day Federal Register Notice.pdf Supplementary Document Uploaded 2015-06-24 Available
Att A-3. PPHF.pdf Supplementary Document Uploaded 2015-06-24 Available
Att A-2. Familly Smoking Prevention & Tobacco Control Act.pdf Supplementary Document Uploaded 2015-06-24 Available
Att A-1. Public Health Service Act.doc Supplementary Document Uploaded 2015-06-24 Available
SS Part B 0920-05PI Extended Evaluation of TPCPEC_091015.docx Supporting Statement B Uploaded 2015-09-10 Available
SS Part A 0920-15PI_09 10 15.docx Supporting Statement A Uploaded 2015-09-10 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
218056 Smoker Survey - Wave A Form NewSmoker Survey Wave A
217194 Non-smoker Survey - Wave D Form NewNonsmoker Survey Wave D
217193 Non-smoker Survey - Wave C Form NewNonsmoker Survey Wave C
217192 Non-smoker Survey - Wave B Form NewNonsmoker Survey Wave B
217191 Non-smoker Survey - Wave A Form NewNonsmoker Survey Wave A
217190 Smoker Survey - Wave D Form NewSmoker Survey Wave D
217189 Smoker Survey - Wave C Form NewSmoker Survey Wave C
217188 Smoker Survey - Wave B Form NewSmoker Survey Wave B
217186 Screener and Consent Form and Instruction NewScreening and Consent Questionnaire

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2017 24 Months From Approved
52,000 0 0
15,583 0 0
0 0 0





Reginfo record details
9
table that charts list of burden
IC Title Form No. Form Name
Non-smoker Survey - Wave A none
Non-smoker Survey - Wave B none
Non-smoker Survey - Wave C none
Non-smoker Survey - Wave D none
Screener and Consent none
Smoker Survey - Wave A none
Smoker Survey - Wave B none
Smoker Survey - Wave C none
Smoker Survey - Wave D none

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 52,000 0 0 52,000 0 0
Annual Time Burden (Hours) 15,583 0 0 15,583 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No