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Federal forms, ICRs, and supporting documents

Information Collection

Nicotine Education Project: Qualitative Study to Gain Insights from Adult Current and Former Smokers to Educate the General Public about Changing Nicotine Standards

IC 237278 under ICR 202007-0910-005 · OMB 0910-0796.

Documents and Forms
Document Name
Document Type
Other-Consent Form
Other-Screener
Other-Screener Contact Sheet
Other-Moderator Guide
Other-Check in Survey Current Smoker
Other-Check in Survey Fomer Smokers
Other-Check in Survey Fomer Smokers
Other-Check Out Form
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Nicotine Education Project: Qualitative Study to Gain Insights from Adult Current and Former Smokers to Educate the General Public about Changing Nicotine Standards CTP
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Consent Form Appendix A_Consent Form.docx No   Fillable Printable
Other-Screener Appendix B_Screener_OMBEditClean 11.20.19.docx No   Paper Only
Other-Screener Contact Sheet Appendix C_Screener Contact Sheet.docx No   Printable Only
Other-Moderator Guide Appendix D_Moderator Guide Clean 11.12.19.docx No   Paper Only
Other-Check in Survey Current Smokers Appendix E1 Check in Survey Current Smokers.docx No   Paper Only
Other-Check in Survey Fomer Smokers Nicotine Appendix E2.docx No   Paper Only
Other-Check in Survey Fomer Smokers No Nicotine Appendix E3.docx No   Paper Only
Other-Check Out Form Appendix F_Check Out Form.docx No   Paper Only

Health Consumer Health and Safety

 

810 0
   
Individuals or Households
 
   0 %

  Requested 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 810 0 0 0 0 810
Annual IC Time Burden (Hours) 488 0 0 0 0 488
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Justification Memo OMB Memo Clean 11 20 2019.docx 11/20/2019
IRB Approval Nicotine Education Project_Advarra IRB.pdf 08/08/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.