Number to Complete the Screener (10%) Reconduct Survey 2

Quantitative Information in Direct-to-Consumer Television Advertisements Survey

Documents and Forms

Document Name Document Type
Appendix D - SCREENER.doc Other-Screener
Appendix E - RECRUITMENT EMAILS.doc Recruitment email IC Document

Information Collection (IC) Details

IC Title:	Number to Complete the Screener (10%) Reconduct Survey 2	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-Screener			Appendix D - SCREENER.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: 1,513	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	1,513	1,513
Annual IC Time Burden (Hours)	76	76
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Recruitment email	Appendix E - RECRUITMENT EMAILS.doc	05/10/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.