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Federal forms, ICRs, and supporting documents

Information Collection

Youth Baseline Questionnaire (Male Rural Smokeless)

IC 208710 under ICR 201512-0910-002 · OMB 0910-0753.

Documents and Forms
Document Name
Document Type
Other-Youth Baseline
Other-Rationale for Changes to Basel
Other-Study Description
Other-Email Reminder 1
Other-Email Reminder 2
Other-Email Reminder 3
Other-Permission Assent Consent
Other-Youth Assent Under 18 ExPECTT
Other-Media Tracking
Other-Rationale for Changes to ExPEC
Information Collection (IC) Details

View Information Collection (IC)

Youth Baseline Questionnaire (Male Rural Smokeless)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Youth Baseline Attachment 2_Youth Baseline Instrument (male rural smokeless) 0910-0753.docx Yes Yes Fillable Fileable
Other-Rationale for Changes to Baseline Rationale for Changes to Baseline Instrument (rural male smokeless) 0910-0753.docx No   Printable Only
Other-Study Description Attachment 8_Study Description (male rural smokeless) 0910-0753.doc No   Paper Only
Other-Email Reminder 1 Email_reminder1_ExPECTT 3 0910-0753.doc Yes Yes Fillable Fileable
Other-Email Reminder 2 Email_reminder2_ExPECTT 3 0910-0753.doc Yes Yes Fillable Fileable
Other-Email Reminder 3 Email_reminder3_ExPECTT 3 0910-0753.doc Yes Yes Fillable Fileable
Other-Permission Assent Consent Attachment 6_Permission Assent Consent (male rural smokeless) 0910-0753.doc No   Paper Only
Other-Youth Assent Under 18 ExPECTT Attachment 6c_Youth Assent under 18 ExPECTT 3 0910-0753.doc No   Paper Only
Other-Media Tracking Attachment 4_Media Tracking Instrument ExPECTT 3 0910-0753.docx Yes Yes Fillable Fileable
Other-Rationale for Changes to ExPECTT Media Tracking Rationale for Changes to ExPECTT 3 Media Tracking Instrument 0910-0753.docx No   Printable Only

Health Consumer Health and Safety

 

656 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 656 0 0 0 0 656
Annual IC Time Burden (Hours) 328 0 0 0 0 328
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
No associated records found
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.