View Information Collection (IC)
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Parent Of Youth Baseline Survey Participants
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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
Other-Email Reminder 3 ExPECTT
Attachment 21_E1. Email_reminder3_ExPECTT.doc
Yes
No
Printable Only
Other-Parent Screener and Instrument (male rural smokeless)
Attachment 3_Parent Screener and Instrument (male rural smokeless) 0910-0753.docx
Yes
Yes
Fillable Fileable
Other-Lead Letter (male rural smokeless)
Attachment 10_R. Lead Letter (male rural smokeless) FU4.docx
No
Paper Only
Other-Lead Letter ExPECTT 1
Attachment 10_E1. Lead Letter ExPECTT.doc
No
Paper Only
Other-Lead Letter ExPECTT 2
Attachment 10_E2a. Lead Letter ExPECTT Baseline.docx
No
Paper Only
Other-Survey Invitation Email ExPECTT
Attachment 18_E1. Survey_invitation_email_ExPECTT.doc
No
Printable Only
Other-Survey Invitation Email (male rural smokeless)
Attachment 18_R. Survey Invitation Email (male rural smokeless).docx
No
Printable Only
Other-Email Reminder 1 ExPECTT
Attachment 19_E1. Email_reminder1_ExPECTT.doc
Yes
No
Printable Only
Other-Mail Reminder 2ExPECTT
Attachment 20_E1. mail_reminder2_ExPECTT.doc
No
Paper Only
Other-Parent Guardian Instrument ExPECTT
Attachment 3_E2c. Parent or Guardian Instrument.doc
Yes
Yes
Fillable Fileable
Other-Introduction to Study
Attachment 7_E2. Introduction to Study.doc
Yes
No
Printable Only
Other-Study Description
Attachment 8_E2. Study Description.docx
No
Printable Only
Other-Q&As about the ExPECTT Evaluation
Attachment 11_E2. Q&As about the ExPECTT Evaluation.docx
No
Paper Only
Other-Questions and Answers (male rural smokeless)
Attachment 11_R. Questions and Answers (male rural smokeless) FU4.docx
Yes
No
Printable Only
Other-Telephone Verification Survey ExPECTT
Attachment 12_E2. Telephone Verification Survey ExPECTT.doc
No
Printable Only
Other-Field Interviewer Verification (male rural smokeless)
Attachment 12_R. Field Interviewer Verification (male rural smokeless) FU4.docx
No
Printable Only
Other-Notifications ExPECTT
Attachment 13_E2. Notifications ExPECTT.doc
No
Paper Only
Other-Panel Maintenance ExPECTT
Attachment 15_E1. Panel Maintenance ExPECTT.docx
No
Paper Only
Other-Panel Maintenance Letter ExPECTT
Attachment 15_E2. Panel Maintenance Letter ExPECTT.docx
No
Paper Only
Other-Panel Maintenance Letter (male rural smokeless)
Attachment 15_R. Panel Maintenance Letter (male rural smokeless) FU4.docx
No
Paper Only
Other-Panel_Maint_Update_Form (male rural smokeless)
Attachment 16_R. Panel_Maint_Update_Form (male rural smokeless) FU4.docx
No
Paper Only
Other-Notifications (male rural smokeless)
Attachment 14_R. Notifications (male rural smokeless) FU4.docx
No
Paper Only
Other-Panel Maintenance Email (male rural smokeless)
Attachment 22_R. Panel Maintenance Email (male rural smokeless) FU4.docx
Yes
No
Printable Only
Other-Email_Reminder 1 (male rural smokeless)
Attachment 19_R. Email_Reminder 1 (male rural smokeless) FU4.docx
Yes
No
Printable Only
Other-Email_Reminder 2 (male rural smokeless)
Attachment 20_R. Email_Reminder 2 (male rural smokeless) FU4.docx
Yes
No
Printable Only
Other-Email_Reminder 3 (male rural smokeless)
Attachment 21_R. Email_Reminder 3 (male rural smokeless) FU4.docx
Yes
No
Printable Only
Other-Post Card Reminder Notice
Attachment 36_R. Post_Card_Reminder_Notice FU4.docx
No
Paper Only
Other-Text Message for Non-responders
Attachment 37_R. Text Message for Non-responders FU4.docx
Yes
No
Printable Only
Other-Email Reminder 3 ExPECTT 1st and 2nd FU
Attachment 21_E2a. Email_reminder3 ExPECTT 1st and 2nd FU.doc
Yes
No
Printable Only
Other-Email Reminder 3 ExPECTT 3rd FU
Attachment 21_E2b. Email_reminder3 ExPECTT 3rd FU.docx
Yes
No
Printable Only
Other-Parent Guardian Consent
Attachment 6_E2e. Parent Guardian Consent.docx
Yes
No
Printable Only
Other-Lead Letter ExPECTT 2 - 1st and 2nd FU
Attachment 10_E2b. Lead Letter ExPECTT 1st and 2nd FU.docx
Yes
No
Printable Only
Other-Lead Letter ExPECTT 2 - 3rd FU
Attachment 10_E2c. Lead Letter ExPECTT 3rd FU.docx
Yes
No
Printable Only
Other-Email Reminder 1 ExPECTT (2) 1st and 2nd FU
Attachment 19_E2a. Email_reminder1_ExPECTT 1st and 2nd FU.docx
Yes
No
Printable Only
Other-Email Reminder 1 ExPECTT (2) 3rd FU
Attachment 19_E2b. Email_reminder1 ExPECTT 3rd FU.docx
Yes
No
Printable Only
Other-Survey Invitation-email ExPECTT (2) 1st and 2nd FU
Attachment 18_E2a. Survey_invitation-email ExPECTT 1st and 2nd FU.docx
Yes
No
Printable Only
Other-Survey Invitation-email ExPECTT (2) 3rd FU
Attachment 18_E2b. Survey_invitation-email ExPECTT 3rd FU.docx
Yes
No
Printable Only
Other-Email Reminder2 ExPECTT (2) 1st and 2nd FU
Attachment 20_E2a. Email_reminder2 ExPECTT 1st and 2nd FU.docx
Yes
No
Printable Only
Other-Email Reminder 2 ExPECTT (2) 3rd FU
Attachment 20_E2b. Email_reminder2 ExPECTT 3rd FU.docx
Yes
No
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:
6,009
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
6,009
0
0
0
0
6,009
Annual IC Time Burden (Hours)
1,022
0
0
0
0
1,022
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.
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.