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Federal forms, ICRs, and supporting documents

Information Collection

LGBT Campaign: Wave 1B Online Quantitative Study Designed to Prevent Young Adult Tobacco Use

IC 225031 under ICR 201802-0910-012 · OMB 0910-0810.

Documents and Forms
Document Name
Document Type
Other-Screener
Other-Questionnaire
Other-Informed Consent Form
Other-Reminder Emails
Other-Social Media Ads
Other-Video Ad Stimuli
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

LGBT Campaign: Wave 1B Online Quantitative Study Designed to Prevent Young Adult Tobacco Use CTP
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Reminder Emails Attachment D_Reminder Emails (+++).docx Yes No Printable Only
Other-Social Media Ads Attachment E_Social Media Ads (++).pdf Yes No Printable Only
Other-Video Ad Stimuli Attachment F_Video Ad Stimuli.doc Yes No Printable Only
Other-Screener Attachment A_Screener (+++).docx Yes Yes Fillable Fileable
Other-Questionnaire Attachment B_Questionnaire (+++).docx Yes Yes Fillable Fileable
Other-Informed Consent Form Attachment C_Informed Consent Form (+++).docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

3,150 0
   
Individuals or Households
 
   0 %

  Requested 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 3,150 0 0 0 0 3,150
Annual IC Time Burden (Hours) 427 0 0 0 0 427
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement A LGBT Campaign GenIC_Part A_Quantitative Supporting Statement (TFL)_OMB+++.docx 01/04/2017
Supporting Statement B Part B_Quantitative Supporting Statement (TFL) (+++).docx 01/04/2017
IRB Letter Attachment G_IRB Letter.pdf 01/04/2017
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.