Information Collection

Nicotine Education Project

IC 251913 under ICR 202112-0910-006 · OMB 0910-0810.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0810 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix A NEP Online Survey Young Adult Consent Form.docx	Other-Young Adult Consent Form
Appendix B NEP Online Survey Youth Assent Form.docx	Other-Youth Assent Form
Appendix C NEP Online Survey.docx	Other-Survey Instrument
IRB Approval NEP.pdf IRB Approval Document	IC Document
OMB_Supporting Statement_Part A_NEP Clean 5.31.docx Supporting Statement A	IC Document
OMB_Supporting Statement_Part B_NEP Clean 5.31.docx Supporting Statement B	IC Document

IC Title:

Nicotine Education Project

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Young Adult Consent Form	Appendix A NEP Online Survey Young Adult Consent Form.docx	Yes	Yes	Fillable Fileable
Other-Youth Assent Form	Appendix B NEP Online Survey Youth Assent Form.docx	Yes	Yes	Fillable Fileable
Other-Survey Instrument	Appendix C NEP Online Survey.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: 8,040

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	12,048	12,048
Annual IC Time Burden (Hours)	1,254	1,254
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
IRB Approval Document	IRB Approval NEP.pdf	03/10/2022
Supporting Statement A	OMB_Supporting Statement_Part A_NEP Clean 5.31.docx	05/31/2022
Supporting Statement B	OMB_Supporting Statement_Part B_NEP Clean 5.31.docx	05/31/2022

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