View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Rough Cut Testing of Spanish, Chinese, Korean, and Vietnamese Print Advertisements for the 2015 Tips Campaign 15DT
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Screener in Chinese Attachment 1a(C) Screener Chinese 10272014.pdf Yes Yes Fillable Fileable
Form none Screener in Korean Attachment 1a(K) Screener Questionnaire Korean 10272014.pdf Yes Yes Fillable Fileable
Form none Screener in Spanish Attachment 1a(S) Screener Spanish 10272014.pdf Yes No Fillable Fileable
Form none Screener in Vietnamese Attachment 1a(V) Screener Vietnamese 10272014.pdf Yes Yes Fillable Fileable
Form none Main Questionnaire in Chinese Attachment 1b(C) Questionnaire Chinese 10272014.pdf Yes Yes Fillable Fileable
Form none Main Questionnaire in Korean Attachment 1b(K) Questionnaire Korean 10272014.pdf Yes Yes Fillable Fileable
Form none Main Questionnaire in Spanish Attachment 1b(S) Questionnaire Spanish 10272014.pdf Yes Yes Fillable Fileable
Form none Main Questionnaire in Vietnamese Attachment 1b(V) Questionnaire Vietnamese 10272014.pdf Yes Yes Fillable Fileable

Health Consumer Health and Safety

 

4,648 0
   
Individuals or Households
 
   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 4,648 0 4,648 0 0 0
Annual IC Time Burden (Hours) 684 0 684 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
SS Part A GenIC 14_Part A 11042014.docx 11/13/2014
SS Part B GenIC 14_Part B 11042014.docx 11/13/2014
Email Invitation Chinese Attachment 2(C) Initial Email Invitation Chinese 10272014.pdf 11/13/2014
Email Invitation Korean Attachment 2(K) Initial Email Invitation Korean 10272014.pdf 11/13/2014
Email Invitation Spanish Attachment 2(S) Initial Email Invitation Spanish 10272014.pdf 11/13/2014
Email Invitation Vietnamese Attachment 2(V) Initial Email Invitation Vietnamese 10272014.pdf 11/13/2014
Toluna Privacy Policy Spanish Attachment 3(S) Privacy Policy Spanish 10272014.pdf 11/13/2014
Toluna Privacy Policy Chinese Attachment 3(C) Privacy Policy Chinese 10272014.pdf 11/13/2014
Toluna Privacy Policy Korean Attachment 3(K) Privacy Policy Korean 10272014.pdf 11/13/2014
Toluna Privacy Policy Vietnamese Attachment 3(V) Toluna Privacy Policy Vietnamese 10272014.pdf 11/13/2014
Terms and conditions Chinese Attachment 4(C) Terms and Conditions Chinese 10272014.pdf 11/13/2014
Terms and Conditions Korean Attachment 4(K) Terms and Conditions Korean 10272014.pdf 11/13/2014
Terms and Conditions Spanish Attachment 4(S) Terms and Conditions Spanish 10272014.pdf 11/13/2014
Terms and Conditions Vietnamese Attachment 4(V) Terms and Conditions Vietnamese 10272014.pdf 11/13/2014
Annotated Screen Shots in Spanish Attachment 5(S) Screen Shots in Spanish 10272014.pdf 11/13/2014
Annotated Screenshots in Chinese Attachment 5(C) Screen Shots in Chinese 10272014.pdf 11/13/2014
Annotated Screenshots in Korean Attachment 5(K) Screen Shots in Korean 10272014.pdf 11/13/2014
Annotated Screenshots in Vietnamese Attachment 5(V) Screen Shots in Vietnamese 10272014.pdf 11/13/2014
Screener in English Att 1a(E)_Screener English.docx 11/13/2014
Main Questionnaire in English Att 1b_MainQuestionnaire Tips 2015 v10.docx 11/13/2014
Email Recruitment in English Att 2(E)_Email Recruitment Rough Cut Tests English.docx 11/13/2014
Toluna Privacy Policy in English Att 3(E)_Privacy Policy English.docx 11/13/2014
Toluna Terms and Conditions in English Att 4(E)_Terms and Conditions English.docx 11/13/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.