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National Tobacco Education Campaign: Rough Cut Testing of TV Advertisments (2020)
Message Testing for Tobacco Communication Activities
OMB: 0920-0910
IC ID: 236135
OMB.report
HHS/CDC
OMB 0920-0910
ICR 201803-0920-021
IC 236135
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0910 can be found here:
2024-09-24 - No material or nonsubstantive change to a currently approved collection
2023-07-31 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
0920 0910 Att 1 - Online Questionnaire Email Invitation to Potential Respondents_Rough Cut Testing 2020.pdf
Other-Screenshot
0920 0910 Att 2 Recuritment Screener_Rough Cut Testing 2020.docx
Other-WORD
0920 0910 Att 3 Online Questionnaire_Rough Cut Testing 2020.docx
Other-WORD
0920 0910 Att 4 - Online Questionnaire Main Screenshots.pdf
Other-Screenshot
0920 0910 Att 5 - Toluna Terms and Conditions_Rough Cut Testing 2020.pdf
Att 5_Toluna USA Membership Site Terms and Conditions
IC Document
0920 0910 Att 6 - IRB Approval Letter.pdf
Att 6_ Battelle IRB
IC Document
0920 0910 Att 7 - Toluna Privacy Policy_Rough Cut Testing 2020.pdf
Att 7_Toluna USA Privacy Policy
IC Document
0920 0910 SSA.docx
SSA
IC Document
0920 0910 SSB.docx
SSB
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
National Tobacco Education Campaign: Rough Cut Testing of TV Advertisments (2020)
Agency IC Tracking Number:
0920-19ASD
IC Status:
New
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-Screenshot
0920 0910 Att 1 - Online Questionnaire Email Invitation to Potential Respondents_Rough Cut Testing 2020.pdf
Yes
Yes
Fillable Fileable
Other-WORD
0920 0910 Att 2 Recuritment Screener_Rough Cut Testing 2020.docx
No
Paper Only
Other-WORD
0920 0910 Att 3 Online Questionnaire_Rough Cut Testing 2020.docx
No
Paper Only
Other-Screenshot
0920 0910 Att 4 - Online Questionnaire Main Screenshots.pdf
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
26,817
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
26,817
0
26,817
0
0
0
Annual IC Time Burden (Hours)
5,593
0
5,593
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Att 5_Toluna USA Membership Site Terms and Conditions
0920 0910 Att 5 - Toluna Terms and Conditions_Rough Cut Testing 2020.pdf
05/23/2019
Att 6_ Battelle IRB
0920 0910 Att 6 - IRB Approval Letter.pdf
05/23/2019
Att 7_Toluna USA Privacy Policy
0920 0910 Att 7 - Toluna Privacy Policy_Rough Cut Testing 2020.pdf
05/23/2019
SSA
0920 0910 SSA.docx
05/23/2019
SSB
0920 0910 SSB.docx
05/23/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.