Follow-up for Callers who Received a Quitline Service

National Quitline Data Warehouse

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0856 can be found here:

Documents and Forms

Document Name Document Type
Form F1 Follow-up for Callers who Received a Quitline Service Form and Instruction
F1 NQDW 7-Month Follow-Up Questionnaire F1 NQDW 7-month Follow-up Questionnaire_Final.docx Form and Instruction
F2. NQDW Advance Letter for Folllow-up.doc F2 IC Document

Information Collection (IC) Details

IC Title:	Follow-up for Callers who Received a Quitline Service	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Removed

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
Form and Instruction	F1	NQDW 7-Month Follow-Up Questionnaire	F1 NQDW 7-month Follow-up Questionnaire_Final.docx		No	No	Fillable Fileable

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 28,900	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	-28,900	28,900
Annual IC Time Burden (Hours)	-3,372	3,372
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
F2	F2. NQDW Advance Letter for Folllow-up.doc	09/19/2012

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