Information Collection

Media Tracking Screener

IC 208713 under ICR 201512-0910-002 · OMB 0910-0753.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0753 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment 4_Media Tracking Instrument ExPECTT 3 0910-0753.docx	Other-Media Tracking
Rationale for Changes to ExPECTT 3 Media Tracking Instrument 0910-0753.docx	Other-Rationale for Changes to ExpEC

IC Title:

Media Tracking Screener

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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
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

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 39,999

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	Previously Approved
Annual Number of Responses for this IC	39,999	39,999
Annual IC Time Burden (Hours)	1,200	1,200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
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.