Information Collection

National Tobacco Education Campaign: Rough Cut Testing of TV Advertisments (2020)

IC 236135 under ICR 201803-0920-021 · OMB 0920-0910.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0910 can be found here:

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	Instrument File	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

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 Agency Discretion
Annual Number of Responses for this IC	26,817	26,817
Annual IC Time Burden (Hours)	5,593	5,593
Annual IC Cost Burden (Dollars)	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.