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Survey Pretests
National Youth Tobacco Surveys 2024 2026
OMB: 0920-0621
IC ID: 229814
OMB.report
HHS/CDC
OMB 0920-0621
ICR 202312-0920-008
IC 229814
( )
Documents and Forms
Document Name
Document Type
Form 0920-0621
Survey Pretests
Form and Instruction
0920-0621 Cognitive Interview Item Form
0621 NYTS Att N5 Cognitive Interview Items_final.docx
Form and Instruction
0920-0621 Cognitive Interview Item Form
0621_NYTS_Att_N5_Cognitive Interview Items_20240520_clean_.docx
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Survey Pretests
Agency IC Tracking Number:
0920-0621
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
0920-0621
Cognitive Interview Item Form
0621_NYTS_Att_N5_Cognitive Interview Items_20240520_clean_.docx
N/A
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
100
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
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
100
0
70
0
0
30
Annual IC Time Burden (Hours)
75
0
52
0
0
23
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.