Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Current, Former, and Recently Denied WIC Participants (Individuals/Households) New 16727 3474 0 Other-Appendix B3.a Certification Survey Version A (Adult) - English
Other-Appendix B3.b Ceritfication Survey Version B (Infant/Child) - English
Other-Appendix B3.c Certification Survey Version A (Adult) - Spanish
Other-Appendix B3.d Certification Survey Version B (Infant/Child) - Spanish
Other-Appendix B4.a Denied Applicant Survey Version A (Adult) - English
Other-Appendix B4.b Denied Applicant Survey Version B (Infant/Child) - English
Other-Appendix B4.c Denied Applicant Survey: Version A (Adult) - Spanish
Other-Appendix B4.d Denied Applicant Survey Version B (Infant/Child) - Spanish
Other-Appendix B5.a Program Experiences Survey Version A (Adult) - English
Other-Appendix B5.b Program Experiences Survey Version B (Infant/Child) - English
Other-Appendix B5.c Program Experiences Survey Version A (Adult) - Spanish
Other-Appendix B5.d Program Experiences Survey Version B (Infant/Child) - Spanish
Other-Appendix B6.a Former WIC Participant Case Study Interview Guide - English
Other-Appendix B6.b Former WIC Participant Case Study Interview Guide - Spanish
Other-Appendix C11.a Certifcation Survey Recruitment Telephone Script - English
Other-Appendix C11.b Certification Survey Recruitment Telephone Script - Spanish
Other-Appendix C12.a Certification Survey recruitment In-Person Script - English
Other-Appendix C12.b Certification Survey Recruitment In-Person Script - Spanish
Other-Appendix C14.a Telephone Reminder for Scheduled Certification Survey - English
Other-Appendix C14.b Telephone Reminder for Scheduled Certification Survey - Spanish
Other-Appendix C15.a Denied WIC Applicant Survey Recruitment Telephone Script - English
Other-Appendix C15.b Denied WIC Applicant Survey Recruitment Telephone Script - Spanish
Other-Appendix C16.a Denied WIC Applicant Survey Recruitment In-Person Script - English
Other-Appendix C16.b Denied WIC Applicant Survey Recruitment In-Person Script - Spanish
Other-Appendix C18.a Telephone Reminder for Scheduled Denied Applicant Survey - English
Other-Appendix C18.b Telephone Reminder for Scheduled Denied Applicant Survey - Spanish
Other-Appendix C19.a Program Experiences Survey Invitation Telephone Script - English
Other-Appendix C19.b Program Experiences Survey Invitation Telephone Script - Spanish
Other-Appendix C22.a Program Experiences Survey Invitaton In-Person Script - English
Other-Appendix C22.b Program Experiences Survey Invitation In-Person Script - Spanish
Other-Appendix C23.a Former WIC Participant Case Study Interview Invitation Telephone Script - English
Other-Appendix C23.b Former WIC Participant Case Study Interview Invitation Telephone Script - Spanish
Other-Appendix D7.a Participant Consent Form - Certification Survey - English
Other-Appendix D7.b Participant Consent Form - Certification Survey-Spanish
Other-Appendix D9.a Participant Consent Form - Denied Applicant Survey - English
Other-Appendix D9.b Participant Consent Form - Denied Applicant Survey - Spanish
Current, Former, and Recently Denied WIC Participants - Non-Respondents (Individuals/Households) New 23661 470 0 Other-Non Respondents Burden Instrument
State and Local WIC Agency Directors (SLT) New 4814 1121 0 Other-Appendix B1.b State Agency Survey - Screenshots
Other-Appendix B2.a Local Agency Survey
Other-Appendix B2.b Local Agency Survey - Screenshots
Other-Appendix B7.a Denied Applicant Log Request Email
Other-Appendix B7.b Denied Applicant Log
Other-Appendix B7.d Denied Applicant Log Request Reminder Telephone Script
Other-Appendix B8 State Agency Administrative Data Request Email
Other-Appendix C6 State Agency Survey Reminder Telephone Script
Other-Appendix C10 Local Agency Survey Reminder Telephone Script
Other-Appendix C24 WIC Administrative Data Request to States from Regions
Other-Appendix C25 State Agency Administrative Data Request Reminder Email
Other-Appendix C26 State Agency Administrative Data Request Reminder Telephone Script
Other-Appendix D4 Certification End Date Verification Reminder Telephone Script
Other-Appendix B1.a State Agency Survey
State and Local WIC Agency Directors - Non-respondents (SLT) New 2577 67 0 Other-Non Respondents Burden Instrument
Total burden requested under this ICR: 47779 5132 0  
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