Information Collection

Center for States Media Consumption Survey

IC 220013 under ICR 201706-0970-005 · OMB 0970-0401.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0401 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 1 Center for States Media Consumption Survey	Form and Instruction
1 Media Consumption Survey Instrument Media Consumption Survey Instrument for OMB_020416 (2).docx	Form and Instruction
OMB Fast Track App Center for States Media Consumption Survey 2-4-16-For OMB (2).doc Center for States Media Consumption Survey	IC Document

IC Title:

Center for States Media Consumption Survey

Agency IC Tracking Number:

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 and Instruction	1	Media Consumption Survey Instrument	Media Consumption Survey Instrument for OMB_020416 (2).docx		Yes	Yes	Fillable Printable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 200

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
	Requested	Previously Approved
Annual Number of Responses for this IC	200	200
Annual IC Time Burden (Hours)	50	50
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Center for States Media Consumption Survey	OMB Fast Track App Center for States Media Consumption Survey 2-4-16-For OMB (2).doc	02/08/2016

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