Information Collection

Parent Of Youth Baseline Survey Participants

IC 208712 under ICR 201704-0910-011 · OMB 0910-0753.

Documents and Forms

Documents and forms in this information collection
Document NameDocument Type
Attachment 21_E1. Email_reminder3_ExPECTT.doc Other-Email Reminder 3 ExPECTT
Attachment 3_Parent Screener and Instrument (male rural smokeless) 0910-0753.docx Other-Parent Screener and Instrument
Attachment 10_R. Lead Letter (male rural smokeless).docx Other-ead Letter (male rural smokele
Attachment 10_E1. Lead Letter ExPECTT.doc Other-Lead Letter ExPECTT 1
Attachment 10_E2. Lead Letter ExPECTT.doc Other-Lead Letter ExPECTT 2
Attachment 18_E1. Survey_invitation_email_ExPECTT.doc Other-Survey Invitation Email ExPECT
Attachment 18_R. Survey Invitation Email (male rural smokeless).docx Other-Survey Invitation Email (male
Attachment 19_E1. Email_reminder1_ExPECTT.doc Other-Email Reminder 1 ExPECTT
Attachment 20_E1. mail_reminder2_ExPECTT.doc Other-Mail Reminder 2ExPECTT
Attachment 3_E2c. Parent Guardian Instrument ExPECTT.doc Other-Parent Guardian Instrument ExP
Attachment 7_E2. Introduction to Study.doc Other-Introduction to Study
Attachment 8_E2. Study Description.doc Other-Study Description
Attachment 11_E2. Q&As about the ExPECTT Evaluation.doc Other-Q&As about the ExPECTT Evaluat
Attachment 11_R. Questions and Answers (male rural smokeless).docx Other-Questions and Answers (male ru
Attachment 12_E2. Telephone Verification Survey ExPECTT.doc Other-Telephone Verification Survey
Attachment 12_R. Field Interviewer Verification (male rural smokeless).docx Other-Field Interviewer Verification
Attachment 13_E2. Notifications ExPECTT.doc Other-Notifications ExPECTT
Attachment 15_E1. Panel Maintenance ExPECTT.docx Other-Panel Maintenance ExPECTT
Attachment 15_E2. Panel Maintenance Letter ExPECTT.docx Other-Panel Maintenance Letter ExPEC
Attachment 15_R. Panel Maintenance Letter (male rural smokeless).docx Other-Panel Maintenance Letter (male
Attachment 16_R. Panel_Maint_Update_Form (male rural smokeless).docx Other-Panel_Maint_Update_Form (male
Attachment 14_R. Notifications (male rural smokeless).docx Other-Notifications (male rural smok
Attachment 22_R. Panel Maintenance Email (male rural smokeless).docx Other-Panel Maintenance Email (male
Attachment 19_R. Email_Reminder 1 (male rural smokeless).docx Other-Email_Reminder 1 (male rural s
Attachment 20_R. Email_Reminder 2 (male rural smokeless).docx Other-Email_Reminder 2 (male rural s
Attachment 21_R. Email_Reminder 3 (male rural smokeless).docx Other-Email_Reminder 3 (male rural s

Information Collection (IC) Details

View Information Collection (IC)

layout table

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-Email Reminder 3 ExPECTT Yes No Printable Only
Other-Parent Screener and Instrument (male rural smokeless) Yes Yes Fillable Fileable
Other-ead Letter (male rural smokeless) No   Paper Only
Other-Lead Letter ExPECTT 1 No   Paper Only
Other-Lead Letter ExPECTT 2 No   Paper Only
Other-Survey Invitation Email ExPECTT No   Printable Only
Other-Survey Invitation Email (male rural smokeless) No   Printable Only
Other-Email Reminder 1 ExPECTT Yes No Printable Only
Other-Mail Reminder 2ExPECTT No   Paper Only
Other-Parent Guardian Instrument ExPECTT Yes Yes Fillable Fileable
Other-Introduction to Study Yes No Printable Only
Other-Study Description No   Printable Only
Other-Q&As about the ExPECTT Evaluation No   Paper Only
Other-Questions and Answers (male rural smokeless) Yes No Printable Only
Other-Telephone Verification Survey ExPECTT No   Printable Only
Other-Field Interviewer Verification (male rural smokeless) No   Printable Only
Other-Notifications ExPECTT No   Paper Only
Other-Panel Maintenance ExPECTT No   Paper Only
Other-Panel Maintenance Letter ExPECTT No   Paper Only
Other-Panel Maintenance Letter (male rural smokeless) No   Paper Only
Other-Panel_Maint_Update_Form (male rural smokeless) No   Paper Only
Other-Notifications (male rural smokeless) No   Paper Only
Other-Panel Maintenance Email (male rural smokeless) Yes No Printable Only
Other-Email_Reminder 1 (male rural smokeless) Yes No Printable Only
Other-Email_Reminder 2 (male rural smokeless) Yes No Printable Only
Other-Email_Reminder 3 (male rural smokeless) Yes No Printable Only

Federal Enterprise Architecture Business Reference Module


table that charts list of burden
  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 6,009 0 0 0 0 6,009
Annual IC Time Burden (Hours) 1,022 0 0 0 0 1,022
Annual IC Cost Burden (Dollars) 0 0 0 0 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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