Information Collection

National Youth Tobacco Survey (NYTS) 2019 Questionnaire

IC 233208 under ICR 201809-0920-007 · OMB 0920-0621.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0621 can be found here:

Documents and Forms

Document Name Document Type
Form 0920-0621 National Youth Tobacco Survey (NYTS) 2019 Questionnaire Form and Instruction
0920-0621 National Youth Tobacco Survey (NYTS) 2019 Questionnaire Attachment_I-1_2019_NYTS_NS_Change_Request.docx Form and Instruction

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	National Youth Tobacco Survey (NYTS) 2019 Questionnaire	Agency IC Tracking Number:	0920-0621-18BCR

Is this a Common Form? No		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
Form and Instruction	0920-0621	National Youth Tobacco Survey (NYTS) 2019 Questionnaire	Attachment_I-1_2019_NYTS_NS_Change_Request.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24,000	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	24,000	24,000
Annual IC Time Burden (Hours)	18,000	18,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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