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Federal forms, ICRs, and supporting documents

Information Collection

Hispanic/Latino Youth and Young Adult Tobacco Use Online Survey Study

IC 257913 under ICR 202308-0910-006 · OMB 0910-0810.

Documents and Forms
Document Name
Document Type
Other-Sample Recruitment Email
Other-Sample Recruitment Email
Other-Survey Screener
Other-Survey Screener
Other-Consent and Assent Form
Other-Consent and Assent Form
Other-Parental Opt Out Form
Other-Parental Opt Out Form
Other-Survey
Other-Survey
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Hispanic/Latino Youth and Young Adult Tobacco Use Online Survey Study CTP
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Sample Recruitment Email Hispanic Audience - Sample Recruitment Email.docx Yes Yes Fillable Fileable
Other-Survey Screener Hispanic Audience Survey Screener.docx Yes Yes Fillable Fileable
Other-Consent and Assent Form Participant Consent_Assent Form.docx Yes Yes Fillable Fileable
Other-Parental Opt Out Form Hispanic Audience Parental Opt Out Form.docx Yes Yes Fillable Fileable
Other-Survey Hispanic Audience Main Survey.docx Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

5,750 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 1,339 0 0 0 0 1,339
Annual IC Time Burden (Hours) 1,339 0 0 0 0 1,339
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Memo (SSA) 0810 SS_Part A_Hispanic Audience Online Survey.docx 02/13/2023
Generic Memo (SSB) 0810 SS_Part B_Hispanic Audience Online Survey.docx 02/13/2023
IRB Approval Hispanic Audience IRB Approval.pdf 02/13/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.