View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Assessment of Tobacco Control Program (TCP) Infrastructure	Agency IC Tracking Number:	15AMD

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
Form and Instruction	None	CMI Measurement Tool	Att. A Interview Guide.docx	None	No		Fillable Fileable

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: 51	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

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	51	0	51	0	0	0
Annual IC Time Burden (Hours)	77	0	77	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
TCP-CMI SSA	TCP-CMI-SSA REVISED.docx	05/28/2015
Introductory Email	Att. B Introductory Email.docx	05/28/2015
Email and Telephone Reminder	Att. C_Email and Telephone Reminders.docx	05/28/2015
Follow Up Email	Att. D Follow up email.docx	05/28/2015
TCP-CMI SSB	TCP-CMI-SSB REVISED.docx	05/28/2015

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