OMB
.report
Search
Media Tracking Questionnaires 1st, 2nd and; 3rd
Evaluation of the Food and Drug Administration's General Market Youth Tobacco Prevention Campaign
OMB: 0910-0753
IC ID: 208714
OMB.report
HHS/FDA
OMB 0910-0753
ICR 201502-0910-009
IC 208714
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0753 can be found here:
2022-04-07 - No material or nonsubstantive change to a currently approved collection
2020-09-23 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
12 Attachment 4_Media Tracking Screener and Instrument 0910-0753.doc
Other-Media Tracking Screener and In
13 Rationale for Item Changes to the ExPECTT Media Tracking Instrument 0901-0753.docx
Other-Rationale for Item Changes to
10 Attachment 2_Youth Follow-up Instrument 0910-0753.doc
Other-Youth Follow up Instrument
11 Rationale for Item Changes to the Follow Up Instrument 0910-0753.docx
Other-Rational for Item Changes to t
0 Contents of OMB Change Request for ExPECTT Second Follow Up.doc
Contents of change request
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Media Tracking Questionnaires 1st, 2nd and; 3rd
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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-Media Tracking Screener and Instrument
12 Attachment 4_Media Tracking Screener and Instrument 0910-0753.doc
Yes
No
Printable Only
Other-Rationale for Item Changes to Media Tracking Instrument
13 Rationale for Item Changes to the ExPECTT Media Tracking Instrument 0901-0753.docx
Yes
No
Printable Only
Other-Youth Follow up Instrument
10 Attachment 2_Youth Follow-up Instrument 0910-0753.doc
Yes
No
Printable Only
Other-Rational for Item Changes to the Follow up Instrument
11 Rationale for Item Changes to the Follow Up Instrument 0910-0753.docx
Yes
No
Printable Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Immunization Management
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,999
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
3,999
0
0
0
0
3,999
Annual IC Time Burden (Hours)
2,001
0
0
0
0
2,001
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Contents of change request
0 Contents of OMB Change Request for ExPECTT Second Follow Up.doc
03/04/2015
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.