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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Cognitive Testing of Supplemental Nutrition Assistance Program Client Integrity Messaging
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
PA Exhibit 1. Informational Flyer
Exhibit 1. Informational Flyer.pdf
No
Fillable Fileable
Form and Instruction
2
PA Exhibit 2. EBT Brochure
Exhibit 2. EBT Brochure.pdf
No
Fillable Fileable
Form and Instruction
3
PA Exhibit 3. Social Media Posting on Scams
Exhibit 3. Social Media Posting on Scams.pdf
No
Fillable Fileable
Form and Instruction
4
PA Exhibit 4. SNAP FAQ
Exhibit 4. SNAP FAQ.pdf
No
Fillable Fileable
Form and Instruction
5
PA Exhibit 5. SNAP Application
Exhibit 5. SNAP Application.pdf
No
Fillable Fileable
Form and Instruction
6
PA Exhibit 6. Excessive Card Letter
Exhibit 6. Excessive Card Letter.pdf
No
Fillable Fileable
Form and Instruction
7
PA Exhibit 7. Fraud FAQs
Exhibit 7. Fraud FAQs.pdf
No
Fillable Fileable
Form and Instruction
8
AL Exhibit 1. AL SNAP Integrity flyer
Exhibit 1. AL SNAP Integrity flyer.pdf
No
Fillable Fileable
Form and Instruction
9
AL Exhibit 2. AL Application
Exhibit 2. AL Application.pdf
No
Fillable Fileable
Form and Instruction
10
DC Exhibit 1. Protecting Benefits Guide
Exhibit 1. Protecting Benefits Guide.pdf
No
Fillable Fileable
Form and Instruction
11
DC Exhibit 2. SNAP Approval Notice
Exhibit 2. SNAP Approval Notice.pdf
No
Fillable Fileable
Form and Instruction
12
DC Exhibit 3. Out of State Travel Flyer
Exhibit 3. Out of State Travel Flyer.pdf
No
Fillable Fileable
Form and Instruction
13
DC Exhibit 4. DC SNAP Website
Exhibit 4. DC SNAP Website.pdf
No
Fillable Fileable
Form and Instruction
14
DC Exhibit 5. SNAP Integrated Application
Exhibit 5. SNAP Integrated Application.pdf
No
Fillable Fileable
Form and Instruction
15
DC Exhibit 6. Multiple Card Replacement Letter
Exhibit 6. Multiple Card Replacement Letter.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:
30
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
30
0
30
0
0
0
Annual IC Time Burden (Hours)
33
0
33
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
OMB Memo
SNAP Program Integrity Message Testing OMB Memo.docx
01/03/2023
Pennsylvania Client Integrity Cognitive Testing Protocol
Attachment 1 Pennsylvania Client Integrity Cognitive Testing Protocol.docx
01/03/2023
Alabama Client Integrity Cognitive Testing Protocol
Attachment 2 Alabama Client Integrity Cognitive Testing Protocol.docx
01/03/2023
Washington DC Client Integrity Cognitive Testing Protocol
Attachment 3 Washington DC Client Integrity Cognitive Testing Protocol.docx
01/03/2023
Recruitment materials
Attachment 4 Recruitment materials.docx
01/03/2023
Incentive Voucher
Attachment 5 Incentive Voucher.docx
01/03/2023
Consent Form
Attachment 6 Consent Form.docx
01/03/2023
Screening questions
Attachment 10 Screening questions.docx
01/03/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.