Information Collection

Youth 1st, 2nd, and; 3rd (Male, Rural Smokeless) follow up questionnaire

IC 208711 under ICR 201606-0910-003 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Document Name Document Type
Attachment 2_R. Youth Followup1 Instrument (male rural smokeless)_REVISED.docx Other-Youth Followup1 Instrument (ma
Attachment 6_R. Youth Assent (male rural smokeless)_REVISED.docx Other-Youth Assent (male rural smoke

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Youth 1st, 2nd, and; 3rd (Male, Rural Smokeless) follow up questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

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
Other-Youth Assent (male rural smokeless)			Attachment 6_R. Youth Assent (male rural smokeless)_REVISED.docx		Yes	Yes	Fillable Fileable
Other-Youth Followup1 Instrument (male rural smokeless)			Attachment 2_R. Youth Followup1 Instrument (male rural smokeless)_REVISED.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,281	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	1,281	1,281
Annual IC Time Burden (Hours)	961	961
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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.