OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Developing Brand & Creative Concepts Designed to Prevent AI/AN Youth Tobacco Use

IC 236942 under ICR 201805-0910-001 · OMB 0910-0796.

Documents and Forms
Document Name
Document Type
Other-Information Packet Materials
Other-Parent_Guardian Permission For
Other-Parent_Guardian Verbal Consent
Other-Participant Assent Form
Other-Moderator Guide
Other-Screener
Other-Check-In Survey
Other-Brand Test Survey Versions A _
Other-Creative Addendum
Other-Creative Concepts Survey
Other-Parent_Guardian Opt-Out
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Developing Brand & Creative Concepts Designed to Prevent AI/AN Youth Tobacco Use CTP
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Information Packet Materials App A.pdf Yes Yes Fillable Fileable Signable
Other-Parent_Guardian Permission Form App A1.docx Yes Yes Fillable Printable
Other-Parent_Guardian Verbal Consent Script App A2.docx Yes Yes Fillable Fileable Signable
Other-Participant Assent Form App B.docx Yes Yes Fillable Printable
Other-Moderator Guide App D.docx Yes No Printable Only
Other-Screener App C.pdf Yes No Printable Only
Other-Check-In Survey App D1.pdf Yes No Fillable Fileable Signable
Other-Brand Test Survey Versions A _ B App D2.pdf Yes Yes Fillable Printable
Other-Creative Addendum App D3.docx Yes Yes Fillable Printable
Other-Creative Concepts Survey App D4.pdf Yes Yes Fillable Printable
Other-Parent_Guardian Opt-Out App A3.docx Yes Yes Fillable Printable

Health Consumer Health and Safety

 

768 0
   
Individuals or Households
 
   0 %

  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 768 0 768 0 0 0
Annual IC Time Burden (Hours) 368 0 368 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Justification Memo Memo.docx 07/19/2019
IRB Approval IRB App.pdf 07/19/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.