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Youth Pre-Test – Outcome Survey
Evaluation of the Food and Drug Administration's 'Fresh Empire' Multicultural Youth Tobacco Prevention Campaign.
OMB: 0910-0788
IC ID: 215943
OMB.report
HHS/FDA
OMB 0910-0788
ICR 201808-0910-001
IC 215943
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0788 can be found here:
2019-02-12 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment 01_Post Campaign Instrument_FU4.docx
Other-Post Campaign Instrument
Attachment 11_Welcome to the Study Letter_FU4.docx
Other-Welcome to the Study Letter
Attachment 17_Verification Call Script.docx
Other-Verification Call Script
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Youth Pre-Test – Outcome Survey
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Unchanged
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-Post Campaign Instrument
Attachment 01_Post Campaign Instrument_FU4.docx
Yes
Yes
Fillable Printable
Other-Welcome to the Study Letter
Attachment 11_Welcome to the Study Letter_FU4.docx
No
Paper Only
Other-Verification Call Script
Attachment 17_Verification Call Script.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
2,194
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
2,194
0
0
0
2,194
0
Annual IC Time Burden (Hours)
1,097
0
0
0
1,097
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.