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Search:
Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Creative Concept Testing Designed to Prevent Youth ENDS, Cigarette ad Other Tobacco Product
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
Appendix A - Parental Permission Form.docx
Yes
Yes
Fillable Printable
Other-Youth Assent Form
Appendix B -Youth Assent Form.docx
Yes
Yes
Fillable Printable
Other-Participant Screener
Appendix C1 - Participant Screener.docx
Yes
Yes
Fillable Printable
Other-Screener Contact Sheet
Appendix C2 -Screener Contact Sheet.docx
Yes
Yes
Fillable Printable
Other-Moderator's Guide
Appendix D-Moderators Guide.doc
No
Printable Only
Other-Concept Rating Sheet
Appendix E - Concept Rating Sheet Clean.docx
No
Paper Only
Other-Concept Ranking Sheet
Appendix F - Concept Ranking Sheet.docx
No
Paper Only
Other-Stimuli
Attachment G - Stimuli Global.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:
8,100
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
8,100
0
8,100
0
0
0
Annual IC Time Burden (Hours)
3,511
0
3,511
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Approval Memo
OMB Approval Memo for Creative Concept Testing 2019.docx
10/31/2019
IRB Letter
FDA_IRB Letter 2019 1025 kdhrc.pdf
10/31/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.