Information Collection

Creative Concept Testing Designed to Prevent Youth ENDS Use in General and Hip Hop Audiences

IC 236392 under ICR 202002-0910-001 · OMB 0910-0796.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0796 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
App A.docx	Other-Parental Permission Form
App B.docx	Other-Youth Assent Form
App C1.docx	Other-Screener
App C2.docx	Other-Screener Contact Sheet
App D1.doc	Other-Discussion Guide
App D2.docx	Other-Products Board
App E.docx	Other-Concept Rating Sheet
App F.docx	Other-Concept Ranking Sheet
Memo.docx Justification Memo	IC Document
Focus Group Stimuli sources w image_OMB R&E Clean.docx Focus Group Stimuli	IC Document

IC Title:

Creative Concept Testing Designed to Prevent Youth ENDS Use in General and Hip Hop Audiences

Agency IC Tracking Number:

CTP

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Parental Permission Form	Yes	Yes	Fillable Printable
Other-Youth Assent Form	Yes	Yes	Fillable Printable
Other-Screener	Yes	Yes	Fillable Printable
Other-Screener Contact Sheet	Yes	Yes	Fillable Printable
Other-Discussion Guide	No		Printable Only
Other-Products Board	Yes	No	Fillable Printable
Other-Concept Rating Sheet	No		Paper Only
Other-Concept Ranking Sheet	No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 1,620

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,620	1,620
Annual IC Time Burden (Hours)	649	649
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Justification Memo		06/10/2019
Focus Group Stimuli		06/28/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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