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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Usability Testing of the FNS SNAP Application
Agency IC Tracking Number:
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
Form and Instruction
1
Indiana SNAP Application
Food Supplement Program-Paper Application Indiana_enclosure 2.pdf
No
Fillable Fileable
Form and Instruction
2
Massachusetts SNAP Application
Food Supplement Program-Paper Application MA_enclosure 2.pdf
No
Fillable Fileable
Form and Instruction
3
Maryland SNAP Application
Food Supplement Program-Paper Application MD_enclosure 2.pdf
No
Fillable Fileable
Form and Instruction
4
Oklahoma SNAP Application
Food Supplement Program-Paper Application Oklahoma_enclosure 2.pdf
No
Fillable Fileable
Form and Instruction
5
Virginia SNAP Application
Food Supplement Program-Paper Application VA_enclosure 2.pdf
No
Fillable Fileable
Form and Instruction
6
MD_ScreenShots_1-50
MD_Scrren Shots 1-50.pdf
No
Fillable Fileable
Form and Instruction
7
MD_Screenshot_51-100
MD_Screenshots 51-100.pdf
No
Fillable Fileable
Form and Instruction
8
MD_Screenshots_101-150
MD_Screenshot 101-150.pdf
No
Fillable Fileable
Form and Instruction
9
MD_Screenshots_151-181
MD_Screenshots 151-181.pdf
No
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
General Government
Subfunction:
Central Records & Statistical Mgt
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
100
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
100
0
100
0
0
0
Annual IC Time Burden (Hours)
183
0
183
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Protocol
protocol enclosure 1.docx
09/24/2019
Demographic Quesitonnaire
demographic questionnaire enclosure 3.docx
09/24/2019
Mobile Device Use Questionnaire
Mobile devise use questionnaire_enclosure 4.docx
09/24/2019
Satisfaction Questionnaire
Satisfaction questionnaire_enclosure 5.docx
09/24/2019
Additional Screener Questions
additional screener question enclosure 6.docx
09/24/2019
Testing Plan
FNS - Usability Test Plan 8.19.19_enclosure 7.docx
09/24/2019
OMB Memo
omb letter_fns_v2.pdf
10/18/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.