Understanding Vaping Practices in the United States Survey

2019 Lung Injury Response Understanding Vaping Practices in the United States

Documents and Forms

Document Name Document Type
Form Survey Understanding Vaping Practices in the United States Survey Form and Instruction
Survey EVALI Survey Attachment 2_EVALI survey v4 CJ final.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Understanding Vaping Practices in the United States Survey	Agency IC Tracking Number:

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	Survey	EVALI Survey	Attachment 2_EVALI survey v4 CJ final.docx		Yes	Yes	Fillable Fileable

Line of Business: Disaster Management

Subfunction: Emergency Response

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 120,000	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	120,000	120,000
Annual IC Time Burden (Hours)	4,000	4,000
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.