Cohort 2--Youth Baseline Questionnaire

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⚠️ Notice: This information collection may be referencing outdated material.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 2_E2a. Youth Baseline Instrument ExPECTT.doc Other-Youth Baseline Instrument ExPE
Attachment 6_E2c. Youth Assent under 18 ExPECTT.doc Other-Youth Assent under 18 ExPECTT

Information Collection (IC) Details

IC Title:	Cohort 2--Youth Baseline Questionnaire	Agency IC Tracking Number:

Is this a Common Form? No		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
Other-Youth Baseline Instrument ExPECTT			Attachment 2_E2a. Youth Baseline Instrument ExPECTT.doc		Yes	Yes	Fillable Fileable
Other-Youth Assent under 18 ExPECTT			Attachment 6_E2c. Youth Assent under 18 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: 2,667	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
Annual Number of Responses for this IC	2,667	2,667
Annual IC Time Burden (Hours)	2,000	2,000
Annual IC Cost Burden (Dollars)	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.