Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Business: Provider Data Manager Modified 157 13 0 Other-App_X Provider Data Request Letter PRAO recommendations CMRev 11-12-14.V2
Business: Provider Data Manager Non Respondents New 39 3 0 Other-Non-Respondent Place Holder
State and Local WIC-Data Mgr. and WIC Staff Modified 2454 362 0 Other-App_O.Ht_Wt SA Admin Data Request.V2 PRAO recommendations 11-12-14.V2
State and Local WIC-Screener, Staff, Personel Non-Response Removed 0 0 0 Other-Non-Respondent Place Holder
WIC Participant Modified 33072 4673 0 Other-App_A.1.Pretest 30 month 14-1028 - English
Other-App_A.2.Pretest 30 month 14-1028 - Spanish
Other-App_C 1 Extension Study Consent_Contact - English PRAO recommendations
Other-App_C 2 Extension Study Consent_Contact - Spanish PRAO recommendations
Other-App_D 1.V2.24 Month Revised Interview - English
Other-App_D.2.V2.24 Month Revised Interview-Spanish
Other-App_E.1.ContactInformationForm-English
Other-App_E.2.ContactInformationForm-Spanish
Other-App G1.30-month interview
Other-App_G.2.30 month Interview - Spanish
Other-App_J.1.36 month Interview 14-1028 - English
Other-App_J.2.36 month Interview 14-1028 - Spanish
Other-App_V.1.HT_WT.MeasurementCard-English-2
Other-App_V.2.HT_WT.MeasurementCard-Spanish-2
Other-App_W.1.HIPAA Letter and Form - English PRAO recommendations 11-12-14
Other-App_W.2.HIPAA Letter and Form - Spanish PRAO recommendations 11-14-14
WIC Participant Non-Response Modified 9355 357 0 Other-Non-Respndent Place Holder
Total burden requested under this ICR: 45077 5408 0  
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