OMB.report

Federal forms, ICRs, and supporting documents

Information Collection

Monthly Monitoring Study: Little Cigar, Cigarillo, and Blunt Use Audience Insights Survey

IC 256409 under ICR 202211-0910-008 · OMB 0910-0810.

Documents and Forms
Document Name
Document Type
Other-LCC and Blunt Use Survey Quest
Other-LCC and Blunt Use Survey Quest
Other-LCC and Blunt Use Survey Scree
Other-LCC and Blunt Use Survey Scree
Other-LCC and Blunt Use Survey Young
Other-LCC and Blunt Use Survey Young
Other-LCC and Blunt Use Survey Youth
Other-LCC and Blunt Use Survey Youth
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Monthly Monitoring Study: Little Cigar, Cigarillo, and Blunt Use Audience Insights Survey CTP
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-LCC and Blunt Use Survey Questionnaire LCC and Blunt Use Survey Questionnaire.docx Yes Yes Fillable Printable
Other-LCC and Blunt Use Survey Screener LCC and Blunt Use Survey Screener.docx Yes Yes Fillable Printable
Other-LCC and Blunt Use Survey Young Adult Consent LCC and Blunt Use Survey Young Adult Consent.docx Yes Yes Fillable Printable
Other-LCC and Blunt Use Survey Youth Assent Form LCC and Blunt Use Survey Youth Assent Form.docx Yes Yes Fillable Printable

Health Consumer Health and Safety

 

10,000 0
   
Individuals or Households
 
   100 %

  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 10,000 0 0 0 0 10,000
Annual IC Time Burden (Hours) 868 0 0 0 0 868
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
OMB Part A Supporting Statement _LCC and Blunt Use Survey OMB Part A Supporting Statement _LCC and Blunt Use Survey.docx 10/13/2022
OMB Part B Supporting Statement _LCC and Blunt Use Survey OMB Part B Supporting Statement _LCC and Blunt Use Survey.docx 10/13/2022
IRB Duke Modification Approval Notice IRB Duke Modification Approval Notice.pdf 10/13/2022
IRB Facing Material Modification Approval Notice IRB Facing Material Modification Approval Notice.pdf 10/13/2022
Monthly Monitoring Study LCC Blunt Use Privacy Protections 0910-0810 - Monthly Monitoring Study LCC Blunt Use Privacy Protections.docx 10/13/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.