Information Collection

Teachers Data Collection Checklist

IC 185554 under ICR 201609-0920-015 · OMB 0920-0621.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0621 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Teachers Data Collection Checklist	Form
Data Collection Checklist Attachment H1_Data Collection Checklist for the National Youth Tobacco Survey.doc	Form
Attachment H2_Letter to Teachers in Participating Schools.doc Letter to Teachers	IC Document

IC Title:

Teachers Data Collection Checklist

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

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
Form	none	Data Collection Checklist	Attachment H1_Data Collection Checklist for the National Youth Tobacco Survey.doc		Yes	No	Fillable Printable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 973

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	973	973
Annual IC Time Burden (Hours)	243	243
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Letter to Teachers	Attachment H2_Letter to Teachers in Participating Schools.doc	12/15/2014

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