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View Information Collection (IC)
View Information Collection (IC)
IC Title:
[NCCDPHP] National Tobacco Education Campaign Rough-Cut Testing of Television Advertisements - Cycle 3
Agency IC Tracking Number:
0920-0910-25AZ
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
0920-0910
Onlline Recruitment Screener
Att 2 - Recruitment Screener_Cycle 3 Rough Cut Testing_20241004.docx
N/A
Yes
Yes
Fillable Fileable
Form and Instruction
0920-0910
Onlline Questionnaire
Att 3 - Questionnaire_Cycle 3 Rough Cut Testing_20241004.docx
N/A
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Public Health Monitoring
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
24,714
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
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
24,714
0
24,714
0
0
0
Annual IC Time Burden (Hours)
2,833
0
2,833
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Invitation Email
Att 1 - Invitation Email_Cycle 3 Rough Cut Testing_20240725.docx
11/07/2024
Online Questionnaire - screenshots
Att 4 - Online Questionnaire Screenshots_Rough Cut Testing_20241007.docx
11/07/2024
Panel Terms and Conditions
Att 5 - Panel Terms and Conditions_Cycle 3 Rough Cut Testing_20240725.pdf
11/07/2024
Panel Privacy Policies
Att 7 - Panel Privacy Policies_Cycle 3 Rough Cut Testing_20240725.pdf
11/07/2024
IRB Exemption
Att 6 - Notice of Exemption IRB 0840 Rev 3.0 Cycle 3 Rough Cut Testing.Sept 2024.pdf
11/07/2024
Secure Link for TV scripts
Secure link for the TV scripts.docx
11/07/2024
Supporting Statement A
Supporting Statement A_Cycle 3 Rough Cut Testing_20241004.docx
11/07/2024
Supporting Statement B
Supporting Statement B_Cycle 3 Rough Cut Testing_20241004.docx
11/07/2024
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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The .gov means it's official.
The site is secure.
