Information Collection

Att E1_State-level Recruitment Script

IC 225824 under ICR 201702-0920-016 · OMB 0920-1205.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1205 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Att E1_State-level Recruitment Script for the National Youth Tobacco Survey.docx	Other-WORD
Att E2_State Letter of Invitation.docx Att E2_State Letter of Invitation	IC Document

IC Title:

Att E1_State-level Recruitment Script

Agency IC Tracking Number:

16AWN

Is this a Common Form? No

IC Status: New

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-WORD			Att E1_State-level Recruitment Script for the National Youth Tobacco Survey.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 6

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6	6
Annual IC Time Burden (Hours)	3	3
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att E2_State Letter of Invitation	Att E2_State Letter of Invitation.docx	02/27/2017

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