General Population Screener and Consent Process (Youth and Parent)

Evaluation of the Food and Drug Administration's General Market Youth Tobacco Prevention Campaign

OMB: 0910-0753

IC ID: 208707

Documents and Forms
Information Collection (IC) Details

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General Population Screener and Consent Process (Youth and Parent)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Parent Permission ExPECTT Attachment 6_E1b. Parent Permission ExPECTT.doc No   Paper Only
Other- Parent Permission ExPECTT (2) Attachment 6_E2b1. Parent Permission ExPECTT Baseline.docx No   Paper Only
Other-Parent Permission (male rural smokeless) Attachment 06_R1. Parent Permission Forms (male rural smokeless) FU4.docx No   Printable Only
Other-Parent Permission ExPECTT FU Attachment 6_E2b2. Parent Permission ExPECTT_FU.docx Yes Yes Fillable Fileable Signable
Other-Parent Guardian Mail Screener B ExPECTT Attachment 3_E2b2. Parent Guardian Mail Screener B ExPECTT.docx Yes Yes Fillable Fileable Signable
Other-Parent Guardian Tablet Screener ExPECTT Attachment 3_E2a. Parent Guardian Tablet Screener ExPECTT.docx Yes Yes Fillable Fileable
Other-Parent Guardian Mail Screener A ExPECTT Attachment 3_E2b1. Parent Guardian Mail Screener A ExPECTT.docx No   Paper Only
Other-Parent Mail_Screener (male rural smokeless) Attachment 3a_Parent Mail_Screener (male rural smokeless) 0910-0753.docx No   Paper Only

Health Consumer Health and Safety

 

30,880 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 30,880 0 0 0 0 30,880
Annual IC Time Burden (Hours) 5,250 0 0 0 0 5,250
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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