OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

2017 NATIONAL YOUTH TOBACCO SURVEY Computer Based Pilot Survey

ICR 201708-0920-020 · OMB 0920-1205 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
SupSta B_NYTS Pilot Revised 1.12.2017 v2 (OSH).docx Supporting Statement B Uploaded 2017-08-23 Available
NYTS Pilot SupSta A_OMB_OSH.docx Supporting Statement A Uploaded 2017-08-23 Available
Att K_Sample Table Shells.xlsx Supplementary Document Uploaded 2017-03-01 Available
Att J_IRB Determination Notice.pdf Supplementary Document Uploaded 2017-03-01 Repair queued
Att D_Publications from Prior Cycles of the National Youth Tobacco Survey.docx Supplementary Document Uploaded 2017-02-27 Available
Att C_State Tobacco Control Reports that Cite National Youth Tobacco Survey Data.docx Supplementary Document Uploaded 2017-03-01 Repair queued
Att B_60day FRN.pdf Supplementary Document Uploaded 2017-02-27 Available
Att A_Authorizing Legislation.docx Supplementary Document Uploaded 2017-02-27 Available
IC Document Collections
IC IDCollectionTypeStatusForm
225941 Att I1_Computer Survey (Screenshots) Other-WORD Modified
225827 Att H1_Data Collection Checklist Other-WORD Unchanged
225826 Att G1_School-level Recruitment Script Other-WORD Unchanged
225825 Att F1_District_level Recruitment Script Other-WORD Unchanged
225824 Att E1_State-level Recruitment Script Other-WORD Unchanged
ICR Details
0920-1205 201708-0920-020
Historical Active 201702-0920-016
HHS/CDC 0920-16AWN
2017 NATIONAL YOUTH TOBACCO SURVEY Computer Based Pilot Survey
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 11/17/2017
Retrieve Notice of Action (NOA) 08/23/2017
  Inventory as of this Action Requested Previously Approved
11/30/2020 36 Months From Approved
6,507 0 0
3,689 0 0
0 0 0
CDC requests OMB approval for one year to conduct a pilot evaluation of an electronic mode of administration of the National Youth Tobacco Survey (NYTS). This Pilot is an electronic-based version of the NYTS previously administered via paper and pencil (PAPI) by CDC in 2004, 2006, 2009, and on an annual basis for years 2011-2016.
PL: Pub.L. 104 - 134 101(d) Name of Law: Research and Investigations
  
None
Not associated with rulemaking
  81 FR 52869 08/10/2016
82 FR 10362 02/10/2017
No
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 6,507 0 0 6,507 0 0
Annual Time Burden (Hours) 3,689 0 0 3,689 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a one time data collection to test the effectiveness of conducting an approved collection (The National Youth Tobacco Survey, OMB Control No. 0920-0621) in an electronic format.
$951,466
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Thelma Sims 4046394771
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/23/2017