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2011 Follow-Up Questionnaire (TUS-CPS)
Next Series of Tobacco Use Supplements to the Current Population Survey (TUS-CPS) (NCI)
OMB: 0925-0368
IC ID: 191981
OMB.report
HHS/NIH
OMB 0925-0368
ICR 201404-0925-002
IC 191981
( )
Documents and Forms
Document Name
Document Type
Form 1
2011 Follow-Up Questionnaire (TUS-CPS)
Form and Instruction
1 May 2011 Follow Up Q
ATTACHMENT 2_May 2011 F-UP Q 12-16-09.doc
Form and Instruction
2 TUS-CPS May 2011 Questionnaire Final
TUS-CPS May 2011 Follow Up Q _AH fnl OMB_1-27-11[1].doc
Form and Instruction
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
2011 Follow-Up Questionnaire (TUS-CPS)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
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
1
May 2011 Follow Up Q
ATTACHMENT 2_May 2011 F-UP Q 12-16-09.doc
Yes
Yes
Fillable Fileable
Form and Instruction
2
TUS-CPS May 2011 Questionnaire Final
TUS-CPS May 2011 Follow Up Q _AH fnl OMB_1-27-11[1].doc
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:
1
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
0
0
0
0
0
0
Annual IC Time Burden (Hours)
0
0
0
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.