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Federal forms, ICRs, and supporting documents

Information Collection

Adult smokers ages 25 to 54; Telephone Verification, Questionnaires 1 - 4

IC 228808 under ICR 201902-0910-011 · OMB 0910-0851.

Documents and Forms
Document Name
Document Type
Other-Telephone Verification Survey
Information Collection (IC) Details

View Information Collection (IC)

Adult smokers ages 25 to 54; Telephone Verification, Questionnaires 1 - 4
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Telephone Verification Survey Attachment_13_POSITEv_Wave_2-4_Telephone_Verification_Survey_W2 Clean.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

436 0
   
Individuals or Households
 
   100 %

  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 436 0 0 0 0 436
Annual IC Time Burden (Hours) 35 0 0 0 0 35
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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.