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Att F1_District_level Recruitment Script
2017 NATIONAL YOUTH TOBACCO SURVEY Computer Based Pilot Survey
OMB: 0920-1205
IC ID: 225825
OMB.report
HHS/CDC
OMB 0920-1205
ICR 201708-0920-020
IC 225825
( )
Documents and Forms
Document Name
Document Type
Att F1_District-level Recruitment Script for the National Youth Tobacco Survey.docx
Other-WORD
Att F2_District Letter of Invitation.docx
F2_District Letter of Invitation
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Att F1_District_level Recruitment Script
Agency IC Tracking Number:
16AWN
Is this a Common Form?
No
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-WORD
Att F1_District-level Recruitment Script for the National Youth Tobacco Survey.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
45
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
45
0
45
0
0
0
Annual IC Time Burden (Hours)
23
0
23
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
F2_District Letter of Invitation
Att F2_District 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.