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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
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

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:

table that charts list of 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 %

table that charts list of burden
	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

table that charts IC Documents
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.