View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

WIC Participant
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-App_A.1.Pretest 30 month 14-1028 - English No   Paper Only
Other-App_A.2.Pretest 30 month 14-1028 - Spanish No   Paper Only
Other-App_C 1 Extension Study Consent_Contact - English PRAO recommendations No   Paper Only
Other-App_C 2 Extension Study Consent_Contact - Spanish PRAO recommendations No   Paper Only
Other-App_D 1.V2.24 Month Revised Interview - English No   Paper Only
Other-App_D.2.V2.24 Month Revised Interview-Spanish No   Paper Only
Other-App_E.1.ContactInformationForm-English No   Paper Only
Other-App_E.2.ContactInformationForm-Spanish No   Paper Only
Other-App G1.30-month interview No   Paper Only
Other-App_G.2.30 month Interview - Spanish No   Paper Only
Other-App_J.1.36 month Interview 14-1028 - English No   Paper Only
Other-App_J.2.36 month Interview 14-1028 - Spanish No   Paper Only
Other-App_V.1.HT_WT.MeasurementCard-English-2 No   Paper Only
Other-App_V.2.HT_WT.MeasurementCard-Spanish-2 No   Paper Only
Other-App_W.1.HIPAA Letter and Form - English PRAO recommendations 11-12-14 No   Paper Only
Other-App_W.2.HIPAA Letter and Form - Spanish PRAO recommendations 11-14-14 No   Paper Only

Income Security Food and Nutrition Assistance

Privacy Act of 1974  5 FR 552

3,281 0
   
Individuals or Households
 
   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 33,072 0 12,517 0 0 20,555
Annual IC Time Burden (Hours) 4,673 0 210 0 0 4,463
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
App_B.1.41904_FeedingBabyFlyer-Eng PRAO recommendations 11-10-14 12/23/2014
App_B.1.41904_FeedingBabyFlyer-Span PRAO recommendations 11-14-14 12/23/2014
App_F.1.V2.30monthadvanceletter - English PRAO recommendations 11-10-14 12/23/2014
App_F.2.V2.30monthadvanceletter - Spanish PRAO recommendations 11-14-14 12/23/2014
App_H.1.ReminderScripts-English PRAO recommendations 11-12-14 02/10/2015
App_H.2.ReminderScripts-Spanish PRAO recommendations 11-14-14 02/10/2015
App_I.1.36monthadvanceletter - English PRAO recommendations 11-12-14 12/23/2014
App_I.2.36monthadvanceletter - Spanish PRAO recommendations 11-14-14 12/23/2014
App_K.1.Birthday Card-English 12/23/2014
App_J.2.36 month 14-1028 - Spanish 12/23/2014
App_U.1.HT_WT.RespondentLetter-English PRAO recommendations 11-12-014 12/23/2014
App_U.2.HT_WT.RespondentLetter-Spanish PRAO recommendations 11-14-14 12/23/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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