Youth Pre-Test – Outcome Survey

Evaluation of the Food and Drug Administration's 'Fresh Empire' Multicultural Youth Tobacco Prevention Campaign.

Documents and Forms

Document Name Document Type
Attachment 01_EFECT_Post_Campaign_Instrument_FU5.docx Other-Post Campaign Instrument
Attachment 17_Verification Call Script_Age 13-17_FU5.docx Other-Verification Call Script

Information Collection (IC) Details

IC Title:	Youth Pre-Test – 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-Post Campaign Instrument			Attachment 01_EFECT_Post_Campaign_Instrument_FU5.docx		Yes	Yes	Fillable Printable
Other-Verification Call Script			Attachment 17_Verification Call Script_Age 13-17_FU5.docx		No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 2,194	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	2,194	2,194
Annual IC Time Burden (Hours)	1,097	1,097
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.