OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Youth 1st, 2nd, and; 3rd (Male, Rural Smokeless) follow up questionnaire

IC 208711 under ICR 201707-0910-016 · OMB 0910-0753.

Documents and Forms
Document Name
Document Type
Other-Youth Followup1 Instrument (ma
Other-Youth Assent (male rural smoke
Other- Incentive Letter (male rural
Other-Consent Forms 18 (male rural s
Other-Lead Letter 18 (male rural smo
Other-Questions and Answers about th
Other- Field Interviewer Verificatio
Other-Survey Invitation Email - 18 (
Other-Email Reminder 1 - 18 (male ru
Other-Email Reminder 2 -18 (male rur
Other-Panel Maintenance Letter - 18
Other- Panel Maintenance Update Form
Other-No Response Reminder Letter -
Other-Panel Maintenance Email - 18 (
Information Collection (IC) Details

View Information Collection (IC)

Youth 1st, 2nd, and; 3rd (Male, Rural Smokeless) follow up questionnaire
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Youth Followup1 Instrument (male rural smokeless) Attachment 2_R. Youth Followup 2 Instrument (male rural smokeless).docx Yes Yes Fillable Fileable
Other-Youth Assent (male rural smokeless) Attachment 6_R. Youth Assent (male rural smokeless).docx Yes Yes Fillable Fileable
Other- Incentive Letter (male rural smokeless) Attachment 23_R. Incentive Letter (male rural smokeless).docx No   Paper Only
Other-Consent Forms 18 (male rural smokeless) Attachment 24_R. Consent Forms 18 (male rural smokeless).docx Yes Yes Fillable Fileable
Other-Lead Letter 18 (male rural smokeless) Attachment 25_R. Lead Letter 18 (male rural smokeless).docx Yes Yes Fillable Fileable
Other-Questions and Answers about the Evaluation 18 (male rural smokeless) Attachment 26_R. Questions and Answers about the Evaluation 18 (male rural smokeless).docx Yes Yes Fillable Fileable
Other- Field Interviewer Verification - 18 (male rural smokeless) Attachment 27_R. Field Interviewer Verification - 18 (male rural smokeless).docx No   Fillable Printable
Other-Survey Invitation Email - 18 (male rural smokeless) Attachment 28_R. Survey Invitation Email - 18 (male rural smokeless).docx No   Printable Only
Other-Email Reminder 1 - 18 (male rural smokeless) Attachment 29_R. Email Reminder 1 - 18 (male rural smokeless).docx No   Printable Only
Other-Email Reminder 2 -18 (male rural smokeless) Attachment 30_R. Email Reminder 2 -18 (male rural smokeless).docx No   Printable Only
Other-Panel Maintenance Letter - 18 (male rural smokeless) Attachment 32_R. Panel Maintenance Letter - 18 (male rural smokeless).docx No   Paper Only
Other- Panel Maintenance Update Form - 18 (male rural smokeless) Attachment 33_R. Panel Maintenance Update Form - 18 (male rural smokeless).docx No   Paper Only
Other-No Response Reminder Letter - 18 (male rural smokeless) Attachment 34_R. No Response Reminder Letter - 18 (male rural smokeless).docx No   Paper Only
Other-Panel Maintenance Email - 18 (male rural smokeless) Attachment 35_R. Panel Maintenance Email - 18 (male rural smokeless).docx Yes No Printable Only

Health Consumer Health and Safety

 

1,281 0
   
Individuals or Households
 
   100 %

  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 1,281 0 0 0 0 1,281
Annual IC Time Burden (Hours) 961 0 0 0 0 961
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.