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Household Screening Respondent
National Panel of Tobacco Consumer Studies
OMB: 0910-0815
IC ID: 216698
OMB.report
HHS/FDA
OMB 0910-0815
ICR 201903-0910-010
IC 216698
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0815 can be found here:
2020-04-28 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment_1_English_Questionnaires_FINAL_CLEAN.PDF
Other-Questionnaires - English
Attachment_2_Spanish_Questionnaires_FINAL_CLEAN.PDF
Other-Questionnaires - Spanish
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Household Screening Respondent
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Removed
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-Questionnaires - English
Attachment_1_English_Questionnaires_FINAL_CLEAN.PDF
Yes
Yes
Fillable Fileable
Other-Questionnaires - Spanish
Attachment_2_Spanish_Questionnaires_FINAL_CLEAN.PDF
Yes
Yes
Fillable Fileable
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:
35,885
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
0
0
0
-11,842
0
11,842
Annual IC Time Burden (Hours)
0
0
0
-1,539
0
1,539
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.