Information Collection

Completes; pretest 3

IC 222608 under ICR 201702-0910-007 · OMB 0910-0824.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Market Claims in DTC Rx Print Ads Appendix A.pdf	Other-Survey Recruit and Consent
Market Claims in DTC Rx Print Ads Appendix B.pdf	Other-Survey Questionnaire

IC Title:

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
Other-Survey Recruit and Consent					Yes	Yes	Fillable Fileable
Other-Survey Questionnaire					Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 108

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	108	108
Annual IC Time Burden (Hours)	27	27
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.

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