Youth 1st, 2nd, 3rd Follow-Up Questionnaire (Experimenter and Non-Trier)

Evaluation of the Food and Drug Administration's General Market Youth Tobacco Prevention Campaign

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0753 can be found here:

Documents and Forms

Document Name Document Type
Attachment 6_E1c. Youth Assent under 18 ExPECTT.doc Other-Youth Assent under 18 ExPECTT
Attachment 6_E1d. Youth Consent 18 and up ExPECTT.doc Other-Youth Consent 18 and up ExPECT
Attachment 6_E1a. Routing for Consent ExPECTT.doc Other-Routing for Consent ExPECTT
Attachment 2_E1. Youth Follow-up Instrument ExPECTT.doc Other-Youth Follow-up Instrument ExP

Information Collection (IC) Details

IC Title:	Youth 1st, 2nd, 3rd Follow-Up Questionnaire (Experimenter and Non-Trier)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Youth Assent under 18 ExPECTT	Attachment 6_E1c. Youth Assent under 18 ExPECTT.doc	No		Printable Only
Other-Youth Consent 18 and up ExPECTT	Attachment 6_E1d. Youth Consent 18 and up ExPECTT.doc	No		Paper Only
Other-Routing for Consent ExPECTT	Attachment 6_E1a. Routing for Consent ExPECTT.doc	Yes	Yes	Fillable Fileable
Other-Youth Follow-up Instrument ExPECTT	Attachment 2_E1. Youth Follow-up Instrument ExPECTT.doc	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 6,666	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	6,666	1,424	5,242
Annual IC Time Burden (Hours)	5,000	1,069	3,931
Annual IC Cost Burden (Dollars)	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.