View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Shopping Patterns: SNAP Recipient Survey (I/H)
Agency IC Tracking Number:
Is this a Common Form?
No
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
Other-FMCS OMB B1 Survey English
FMCS OMB B1 Survey English_v4.docx
No
Paper Only
Other-FMCS OMB B2 Survey Spanish
FMCS OMB B2 Survey Spanish_v4.docx
No
Paper Only
Other-FMCS OMB D1 Telephone Script for Survey via Interview English
FMCS OMB D1 Telephone Script English_v4.docx
N/A - Interview responses are filed electronically
Yes
Yes
Fillable Fileable
Other-FMCS OMB D2 Telephone Script for Survey via Interview Spanish
FMCS OMB D2 Telephone Script Spanish_v4.docx
N/A - Interview responses are filed electronically
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Food and Nutrition Assistance
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
3,724
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
25 %
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
3,724
0
3,724
0
0
0
Annual IC Time Burden (Hours)
3,539
0
3,539
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
FMCS OMB A1 SNAP Participant Study Introductory Letter English
FMCS OMB A1 SNAP Participant Study Introductory Letter English_v4.docx
07/10/2012
FMCS OMB A2 SNAP Participant Study Introductory Letter Spanish
FMCS OMB A2 SNAP Participant Study Introductory Letter Spanish_v4.docx
07/10/2012
FMCS OMB B3 Telephone Survey Screenshots English
FMCS OMB B3 Telephone Survey Screenshots English_v4.doc
07/10/2012
FMCS OMB B4 Telephone Survey Screenshots Spanish
FMCS OMB B4 Telephone Survey Screenshots Spanish_v4.doc
07/10/2012
FMCS OMB C1 SNAP Participant Reminder Letter English
FMCS OMB C1 SNAP Participant Reminder Letter English_v4.docx
07/11/2012
FMCS OMB C2 SNAP Participant Reminder Letter Spanish
FMCS OMB C2 SNAP Participant Reminder Letter Spanish_v4.docx
07/11/2012
FMCS OMB C3 SNAP Participant Thank you letter English
FMCS OMB C3 SNAP Participant Thank you letter English.docx
07/11/2012
FMCS OMB C4 SNAP Participant Thank you letter Spanish
FMCS OMB C4 SNAP Participant Thank you letter Spanish.docx
07/11/2012
FMCS OMB D3 Refusal Conversion English
FMCS OMB D3 Refusal Conversion English_v4.docx
07/11/2012
FMCS OMB D4 Refusal Conversion Spanish
FMCS OMB D4 Refusal Conversion Spanish_v4.docx
07/11/2012
FMCS OMB D5 Automated Phone Calls English
FMCS OMB D5 Automated Phone Calls English_v4.docx
07/11/2012
FMCS OMB D6 Automated Phone Calls Spanish
FMCS OMB D6 Automated Phone Calls Spanish_v4.docx
07/11/2012
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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