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

View Information Collection (IC)

Pretests for an alternate data collection method (ADCM) for FoodAPS2
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Screening questions Yes Yes Fillable Printable
Other-Web-based Food reporting system Yes Yes Fillable Fileable
Other-Income Worksheet web instrument Yes Yes Fillable Fileable
Other-Meal and Snake Form Yes Yes Fillable Fileable
Other-Final Interview Income Questions Yes Yes Fillable Fileable
Other-Screener for Pretest 2 Yes Yes Fillable Fileable
Other-Initial Interview_Pretest 2 Yes Yes Fillable Fileable
Other-Final Interview_Pretest 2 Yes Yes Fillable Fileable

Income Security Food and Nutrition Assistance

 

50 0
   
Individuals or Households
 
   100 %

  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 50 0 50 0 0 0
Annual IC Time Burden (Hours) 263 0 263 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix A_Recruitment Ad 04/14/2016
Appendix D-2-Minor Assent for Pretest 1&2 04/14/2016
Appendix E-Pretest 1 Debriefing Protocol 04/14/2016
Appendix F-Feedback Form_Pretest 2 04/14/2016
Appendix H_Study Fact Sheet 04/14/2016
Study Requesting Memo 04/25/2016
Appendix D-1-Consent Form_Pretest 1 04/25/2016
Appendix D-3-Consent Form_Pretest 2 04/25/2016
Appendix G-1_Disclaimer for Pretest 1 04/25/2016
Appendix G-2_Disclaimer_Pretest 2 04/25/2016
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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