View Information Collection (IC)
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ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
State Agency Respondents
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-H_Master Site Visit Protocol.docx
H_Master Site Visit Protocol.docx
No
Paper Only
Other-I.1_Interview Guide for providers.docx
I.2_Interview Guide for Providers.docx
No
Paper Only
Other-J.3_Focus Group Moderator Guide for Employers.docx
J.3_Focus Group Moderator Guide for Employers.docx
No
Paper Only
Other-M.3_Participant Information Survey - Employer.docx
M.3_Participant Information Survey - Employer.docx
No
Paper Only
Other-V.1_Time Use Survey.docx
V.1_Time Use Survey.docx
No
Paper Only
Other-V.2_Time-Use Survey_ScreenShots.docx
V.2_Time-Use Survey_ScreenShots.docx
CATI at MPR
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Income Security
Subfunction:
Food and Nutrition Assistance
Privacy Act System of Records
Title:
USDA/FNS-10 Persons Doing Business with the Food and Nutrition Service,
FR Citation:
65 FR 17252
Number of Respondents:
20
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
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
620
0
-480
0
0
1,100
Annual IC Time Burden (Hours)
1,105
0
-480
0
0
1,585
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
I.3_Observation Guide.docx
I.3_Observation Guide.docx
12/17/2018
L.3_Focus Group Recruitment Email - Employer.docx
L.3_Focus Group Recruitment Email - Employer.docx
12/17/2018
L.4_Focus Group Confirmation Letter - Employer.docx
L.4_Focus Group Confirmation Letter - Employer.docx
12/17/2018
T_Administrative Data Items.docx
T_Administrative Data Items.docx
12/17/2018
U_Master Pilot Costs Workbook.xlsx
U_Master Pilot Costs Workbook.xlsx
12/17/2018
W.1_Time Use Survey Initial Email.docx
W.1_Time Use Survey Initial Email.docx
12/17/2018
W.2_Time Use Survey Reminder Email.docx
W.2_Time Use Survey Reminder Email.docx
12/17/2018
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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