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Caregivers of Former WIC Children (Individuals/Households)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Appendix A1 Study Extension Consent Age 6 - English App_A1.Study extension consent age 6 - English 8.23.18.docx No   Paper Only
Other-Appendix A2 Study Extension Consent Age 6 - Spanish App_A2.Study extension consent age 6 - Spanish 8.23.18.docx No   Paper Only
Other-Appendix B1 Study Extension Letter - English App_B1.Study extension letter - English 8.23.18.docx No   Paper Only
Other-Appendix B2 Study Extension Letter - Spanish App_B2.Study extension letter - Spanish 8.23.18.docx No   Paper Only
Other-Appendix C1 72-month Advance Letter - English App_C1.72-month advance letter - English 8.24.18.docx No   Paper Only
Other-Appendix C2 72-month Advance Letter - Spanish App_C2.72-month advance letter - Spanish 8.24.18.docx No   Paper Only
Other-Appendix D1 72-month Telephone Interview - English App_D1.72-month telephone interview - English 10-8-18.docx Yes Yes Fillable Fileable
Other-Appendix D2 72-month Telephone Interview - Spanish App_D2.72-month telephone interview - Spanish 10-8-18.docx Yes Yes Fillable Fileable
Other-Appendix D3 72-month Replicate Dietary Intake Interview - English App_D3.72-month replicate dietary intake interview - English 10-8-18.docx Yes Yes Fillable Fileable
Other-Appendix D4 72-month Replicate Dietary Intake Interview - Spanish App_D4.72-month replicate dietary intake interview - Spanish 10-8-18.docx Yes Yes Fillable Fileable
Other-Appendix F1 72-month H/W Measurement Card - English App_F1.72-month HW measurement card - English 10-8-18.docx No   Paper Only
Other-Appendix F2 72-month H/W Measurement Card - Spanish App_F2.72-month HW measurement card - Spanish 10-8-18.docx No   Paper Only
Other-Appendix H1 72-month Text or Email Provider Measures - English App_H1.72-month text or email provider measures - English 8.24.18.docx Yes No Paper Only
Other-Appendix H2 72-month Text or Email Provider Measures - Spanish App_H2.72-month text or email provider measures - Spanish 8.24.18.docx Yes No Paper Only

Income Security Food and Nutrition Assistance

FNS-8 USDA/FNS Studies and Reports  56 FR 19078

2,969 0
   
Individuals or Households
 
   70 %

  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 27,009 0 -74,010 0 0 101,019
Annual IC Time Burden (Hours) 3,831 0 -5,876 0 0 9,707
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix E1a Reminders for Interview from Study Liaison - English App_E1a.Reminders for interview from Study Liaison - English 10.1.18.docx 10/11/2018
Appendix E1b Reminders for Interview from Study Liaison - Spanish App_E1b.Reminders for interview from Study Liaison - Spanish 10.1.18.docx 10/11/2018
Appendix E2a Reminders for Non-Locatable Active Interview - English App_E2a.Reminders for non-locatable active interview - English 10.1.18.docx 10/11/2018
Appendix E2b Reminders for Non-Locatable Active Interview - Spanish App_E2b.Reminders for non-locatable active interview - Spanish 10.1.18.docx 10/11/2018
Appendix E3a Reminders for Study Participation Refusal Conversion - English App_E3a.Reminders for study participation refusal conversion - English 10.1.18.docx 10/11/2018
Appendix E3b Reminders for Study Participation Refusal Conversion - Spanish App_E3b.Reminders for study participation refusal conversion - Spanish 10.1.18.docx 10/11/2018
Appendix E4a Reminders for Study Participation Not Answering Calls - English App_E4a.Reminders for study participation not answering calls - English 10.1.18.docx 10/11/2018
Appendix E4b Reminders for Study Participation Not Answering Calls - Spanish App_E4b.Reminders for study participation not answering calls - Spanish 10.118.docx 10/11/2018
Appendix E5a Reminders for Telephone Research Center Voicemail, First Message - English App_E5a.Reminders for Telephone Research Center voicemail , first message - English 10.1.18.docx 10/11/2018
Appendix E5b Reminders for Telephone Research Center Voicemail, First Message - Spanish App_E5b Reminders for Telephone Research Center voicemail , first message - Spanish 10.1.18.docx 10/11/2018
Appendix E6a Reminders for Telephone Research Center Voicemail, Expiring Interviews - English App_E6a.Reminders for Telephone Research Center voicemail, expiring interview - English 10.1.18.docx 10/11/2018
Appendix E6b Reminders for Telephone Research Center Voicemail, Expiring Interviews - Spanish App_E6b.Reminders for Telephone Research Center voicemail, expiring interview - Spanish 10.1.18.docx 10/11/2018
Appendix G1 Height and Weight Reminders - English App_G1.Height and weight reminders - English 10.1.18.docx 10/11/2018
Appendix G2 Height and Weight Reminders - Spanish App_G2.Height and weight reminders - Spanish 10.1.18.docx 10/11/2018
Appendix I1 72-month Thank You - English App_I1.72-month thank you - English 10.1.8.docx 10/12/2018
Appendix I2 72-month Thank You - Spanish App_I2.72-month thank you - Spanish 10.1.18.docx 10/12/2018
Appendix J1 Birthday Card Respondent Year 6 - English App_J1.Birthday card respondent year 6 - English 10.1.18.docx 10/12/2018
Appendix J2 Birthday Card Respondent Year 6 - Spanish App_J2.Birthday card respondent year 6 - Spanish 10.1.18.docx 10/12/2018
Appendix K1 Birthday Card Child Age 6 - English App_K1.Birthday card child age 6 - English 10.1.18.docx 10/12/2018
Appendix K2 Birthday Card Child Age 6 - Spanish App_K2.Birthday card child age 6 - Spanish10.1.18.docx 10/12/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.