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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Copy Testing of Tobacco Prevention and Cessation Advertisements Research Study
Agency IC Tracking Number:
CTP
IC Status:
Unchanged
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-E-mail prompt/recruit
Copy Testing Sample E-mail Prompt FINAL.docx
Yes
Yes
Fillable Fileable
Other-Consent
Copy Testing Parent and Legal Guardian Consent FINAL.docx
Yes
Yes
Fillable Fileable
Other-Youth assent
Copy Testing Youth Assent FINAL.docx
Yes
Yes
Fillable Fileable
Other-Screener
Copy Testing Screener FINAL.docx
Yes
Yes
Fillable Fileable
Other-Ads/invitation
Copy Testing Sample Social Media Ads FINAL.docx
Yes
Yes
Fillable Fileable
Other-Study stimuli
Copy Testing Study Stimuli FINAL.docx
Yes
No
Printable Only
Other-Survey
Copy Testing Survey Instrument FINAL.docx
Yes
Yes
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:
7,500
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
7,500
0
0
0
0
7,500
Annual IC Time Burden (Hours)
1,000
0
0
0
0
1,000
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
IRB
Copy Testing IRB.pdf
06/09/2023
SSA
Copy Testing SSA FINAL.docx
06/09/2023
SSB
Copy Testing SSB FINAL.docx
06/09/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.