View Information Collection (IC)

View Information Collection (IC)

View Information Collection (IC)

IC Title:	Creative Concept Testing Designed to Prevent Youth ENDS Use in General and Hip Hop Audiences	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-Parental Permission Form			App A.docx		Yes	Yes	Fillable Printable
Other-Youth Assent Form			App B.docx		Yes	Yes	Fillable Printable
Other-Screener			App C1.docx		Yes	Yes	Fillable Printable
Other-Screener Contact Sheet			App C2.docx		Yes	Yes	Fillable Printable
Other-Discussion Guide			App D1.doc		No		Printable Only
Other-Products Board			App D2.docx		Yes	No	Fillable Printable
Other-Concept Rating Sheet			App E.docx		No		Paper Only
Other-Concept Ranking Sheet			App F.docx		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: 1,620	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	1,620	0	1,620	0	0	0
Annual IC Time Burden (Hours)	649	0	649	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Justification Memo	Memo.docx	06/10/2019
Focus Group Stimuli	Focus Group Stimuli sources w image_OMB R&E Clean.docx	06/28/2019

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