Information Collection

Media Tracking Screener

IC 208713 under ICR 201902-0910-009 · OMB 0910-0753.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0753 can be found here:

Documents and Forms

Document Name Document Type
Attachment 4_E2a. Media Tracking Screener ExPECTT.docx Other- Media Tracking Parent Permiss
Attachment 4_E2a2. Media Tracking Youth Assent.docx Other-Media Tracking Youth Assent
Attachment 4_E2a3. Media Tracking Screener.docx Other-Media Tracking Screener

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Media Tracking Screener	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other- Media Tracking Parent Permission	Attachment 4_E2a. Media Tracking Screener ExPECTT.docx	Yes	Yes	Fillable Fileable
Other-Media Tracking Youth Assent	Attachment 4_E2a2. Media Tracking Youth Assent.docx	Yes	Yes	Fillable Fileable
Other-Media Tracking Screener	Attachment 4_E2a3. Media Tracking Screener.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 60,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Previously Approved
Annual Number of Responses for this IC	60,000	60,000
Annual IC Time Burden (Hours)	1,800	1,800
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.