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:
LGBT Campaign: Focus Group Study of Brand and Creative Concepts Designed to Prevent LGBT Young Adult Tobacco Use
Agency IC Tracking Number:
CTP
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
Other-screener
Screener LGBT.docx
No
Printable Only
Other-consent form for participant to retain
Consent Form_Retain LGBT.docx
No
Paper Only
Other-consent form for participant to return
Consent Form_Return LGBT.docx
No
Paper Only
Other-focus group moderator guide
Moderator Guide LGBT.docx
No
Paper Only
Other-survey (brand test v. A)
Brand Test Survey Version A LGBT.docx
No
Paper Only
Other-survey (brand test v. B)
Brand Test Survey Version B LGBT.docx
No
Paper Only
Other-brand test stimuli
Addendum A - Brand Testing Stimuli LGBT.pdf
No
Paper Only
Other-creative concept testing stimuli
Addendum B - Creative Concept Testing Stimuli LGBT.docx
No
Paper Only
Other-creative concept survey
Creative Concept Survey LGBT.xlsx
No
Paper 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:
896
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
896
0
896
0
0
0
Annual IC Time Burden (Hours)
448
0
448
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Abbreviated Supporting Statement/OMB memo 0910-0674 LGBT
OMB Justification Memo_LGBT_BCC.docx
02/13/2015
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.