View Information Collection (IC)
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Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Caregivers of Former WIC Children (Individuals/Households)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
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-App A1 Year 9 Study Consent Form - English - Clean
App A1 Year 9 Study Consent Form - English - Clean.docx
Yes
No
Paper Only
Other-App A2 Year 9 Study Consent Form - Spanish - Clean
App A2 Year 9 Study Consent Form - Spanish - Clean.docx
Yes
No
Paper Only
Other-App B1. Study Extension Letter - English - clean
App B1. Study Extension Letter - English - clean.docx
Yes
No
Paper Only
Other-App B2. Study Extension Letter - Spanish 062421
App B2. Study Extension Letter - Spanish 062421.docx
Yes
No
Paper Only
Other-App_C1. Contact Information Form - English
App_C1. Contact Information Form - English.docx
Yes
No
Paper Only
Other-App_C2. Contact Information Form - Spanish
App_C2. Contact Information Form - Spanish.docx
Yes
No
Paper Only
Other-App_D1. Contact Information Form Reminder- English
App_D1. Contact Information Form Reminder- English.docx
Yes
Yes
Fillable Fileable
Other-App_D2. Contact Information Form Reminder- Spanish
App_D2. Contact Information Form Reminder- Spanish.docx
Yes
Yes
Fillable Fileable
Other-App_E1. Year 9 Interview Advance Letter - English
App_E1. Year 9 Interview Advance Letter - English.docx
No
Paper Only
Other-App_E2. Year 9 Interview Advance Letter- Spanish
App_E2. Year 9 Interview Advance Letter- Spanish.docx
No
Paper Only
Other-App_H1.Year 9 HW measurement card - English
App_H1.Year 9 HW measurement card - English.docx
No
Paper Only
Other-App_H2.Year 9 HW measurement card - Spanish
App_H2.Year 9 HW measurement card - Spanish.docx
No
Paper Only
Other-App_J1.Year 9 text or email provider measures - English
App_J1.Year 9 text or email provider measures - English.docx
Yes
Yes
Fillable Fileable
Other-App_J2.Year 9 text or email provider measures - Spanish
App_J2.Year 9 text or email provider measures - Spanish.docx
Yes
Yes
Fillable Fileable
Other-App_F1. Year 9 telephone interview - English 2_9_21
App_F1. Year 9 telephone interview - English 2_9_21.docx
No
Paper Only
Other-App_F2.Year 9 telephone interview - Spanish 2-9-21_
App_F2.Year 9 telephone interview - Spanish 2-9-21_.docx
No
Paper Only
Other-App_F3.Year 9 replicate dietary intake interview - English
App_F3.Year 9 replicate dietary intake interview - English.docx
No
Paper Only
Other-App_F4. Year 9 replicate dietary intake interview - Spanish
App_F4. Year 9 replicate dietary intake interview - Spanish.docx
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Food and Nutrition Assistance
Privacy Act System of Records
Title:
FNS-8 USDA/FNS Studies and Reports
FR Citation:
56 FR 19078
Number of Respondents:
2,668
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
75 %
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
19,585
0
0
0
0
19,585
Annual IC Time Burden (Hours)
2,860
0
0
0
0
2,860
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
App_G1a.Reminders for Year 9 interview from Study Liaison - English
App_G1a.Reminders for Year 9 interview from Study Liaison - English.docx
10/15/2021
App_G1b.Reminders for Year 9 interview from Study Liaison - Spanish
App_G1b.Reminders for Year 9 interview from Study Liaison - Spanish.docx
10/15/2021
App_G2a.Reminders for Year 9 non-locatable active interview - English
App_G2a.Reminders for Year 9 non-locatable active interview - English.docx
10/15/2021
App_G2b.Reminders for Year 9 non-locatable active interview - Spanish
App_G2b.Reminders for Year 9 non-locatable active interview - Spanish.docx
10/15/2021
App_G3a.Reminders for Year 9 study participation refusal conversion - English
App_G3a.Reminders for Year 9 study participation refusal conversion - English.docx
10/15/2021
App_G3b.Reminders for Year 9 study participation refusal conversion - Spanish
App_G3b.Reminders for Year 9 study participation refusal conversion - Spanish.docx
10/15/2021
App_G4a.Reminders for Year 9 study participant not answering calls - English
App_G4a.Reminders for Year 9 study participant not answering calls - English.docx
10/15/2021
App_G4b.Reminders for Year 9 study participant not answering calls - Spanish
App_G4b.Reminders for Year 9 study participant not answering calls - Spanish.docx
10/15/2021
App_G5a.Reminders for Year 9 Interivew Telephone Research Center voicemail , first message - English
App_G5a.Reminders for Year 9 Interivew Telephone Research Center voicemail , first message - English.docx
10/15/2021
App_G5b Reminders for Year 9 Interview Telephone Research Center voicemail , first message - Spanish
App_G5b Reminders for Year 9 Interview Telephone Research Center voicemail , first message - Spanish.docx
10/15/2021
App_G6a.Reminders for Year 9 Interview Telephone Research Center voicemail, expiring interview - English
App_G6a.Reminders for Year 9 Interview Telephone Research Center voicemail, expiring interview - English.docx
10/15/2021
App_G6b.Reminders for Year 9 Interview Telephone Research Center voicemail, expiring interview - Spanish
App_G6b.Reminders for Year 9 Interview Telephone Research Center voicemail, expiring interview - Spanish.docx
10/15/2021
App_I1.Height and weight reminders - English
App_I1.Height and weight reminders - English.docx
10/15/2021
App_I2.Height and weight reminders - Spanish
App_I2.Height and weight reminders - Spanish.docx
10/15/2021
App_K1.Year 9 thank you - English
App_K1.Year 9 thank you - English.docx
10/15/2021
App_K2.Year 9 thank you - Spanish
App_K2.Year 9 thank you - Spanish.docx
10/15/2021
App_L1.Birthday card respondent year 9 - English
App_L1.Birthday card respondent year 9 - English.docx
10/15/2021
App_L2.Birthday card respondent year 9 - Spanish
App_L2.Birthday card respondent year 9 - Spanish.docx
10/15/2021
App_M1.Birthday card child age 9 - English
App_M1.Birthday card child age 9 - English.docx
10/15/2021
App_M2.Birthday card child age 9 - Spanish
App_M2.Birthday card child age 9 - Spanish.docx
10/15/2021
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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