View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	National Tobacco Prevention and Control Public Education Campaign: Rough Cut Testing of TV Ads	Agency IC Tracking Number:

IC Status: New

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
Instruction			Attachment 1. OSH Rough Cut Testing of TV Ads-Screener-1.6.12.doc		Yes	Yes	Printable Only
Instruction			Attachment 2. OSH Rough Cut Testing of TV Ads-Main Questionnaire-1.6.12.doc		Yes	Yes	Printable Only

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 4,268	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	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	4,268	0	0	0	0	0
Annual IC Time Burden (Hours)	277	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
0920-0910_IC #1TV Rough Cuts 09 2012	0920-0910_IC #1TV Rough Cuts 09 2012.docx	01/12/2012
Attachment 4 HIPoints Terms of Use	Attachment 4 HIPoints Terms of Use.pdf	01/12/2012
Attachment 3 HIPoints Terms Conditions	Attachment 3 HIPoints Terms Conditions.pdf	01/12/2012
Attachment 5 HIPoints Privacy Policy	Attachment 5 HIPoints Privacy Policy.pdf	01/12/2012
New Harris Poll Online Survey	New Harris Poll Online Survey.mht	01/12/2012

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