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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 Messaging for Able-Bodied Adults without Dependents
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
Minnesota Protocol and Materials
Enclosure 3 - Minnesota Protocol and Materials.docx
No
Fillable Fileable
Form and Instruction
2
Wisconsin Protocol and Materials
Enclosure 4 - Wisconsin Protocol and Materials.docx
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
OMB Memo - SNAP ABAWD Message Cognitive Testing in MN and WI.docx
03/13/2023
Recruitment Materials
Enclosure 1 - Recruitment Materials.docx
03/13/2023
Additional Screening Questions
Enclosure 2 - Additional Screening Questions.docx
03/13/2023
Consent Form
Enclosure 5 - Consent Form.docx
03/13/2023
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.