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Adult Parental Permission Process – Outcome Survey
Evaluation of the Food and Drug Administration's 'Fresh Empire' Multicultural Youth Tobacco Prevention Campaign.
OMB: 0910-0788
IC ID: 215942
OMB.report
HHS/FDA
OMB 0910-0788
ICR 201901-0910-003
IC 215942
( )
Documents and Forms
Document Name
Document Type
Attachment 05a_Parental Permission_Youth Assent_Longitudinal Age 12- 17_Household_FU5.docx
Other-Longitudinal Informed Consent
Attachment 08a_Outcome Parent Lead Letter_Longitudinal_FU5.docx
Other-Outcome Parent Lead Letter (Lo
Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU5.docx
Other-Longitudinal Informed Consent
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Adult Parental Permission Process – Outcome Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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
Other-Outcome Parent Lead Letter (Longitudinal)
Attachment 08a_Outcome Parent Lead Letter_Longitudinal_FU5.docx
No
Paper Only
Other-Longitudinal Informed Consent and Assent (Web)
Attachment 05c_Parental Permission_Youth Assent_Longitudinal Age 12-17_Web_FU5.docx
Yes
Yes
Fillable Printable
Other-Longitudinal Informed Consent and Assent (Household)
Attachment 05a_Parental Permission_Youth Assent_Longitudinal Age 12- 17_Household_FU5.docx
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
30,905
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
30,905
0
0
0
0
30,905
Annual IC Time Burden (Hours)
513
0
0
0
0
513
Annual IC Cost Burden (Dollars)
0
0
0
0
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.