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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Household Survey Activities
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
7 CFR 245.6a
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Appendix 12.a Household Survey - English
12a. Household Survey_English.docx
Yes
Yes
Fillable Fileable
Other-Appendix 12.b Household Survey - Spanish
12b. Household Survey_Spanish.docx
Yes
Yes
Fillable Fileable
Other-Appendix 29.a Household Survey Call Script - English
29a. Household survey call script-English.docx
No
Paper Only
Other-Appendix 29.b Household Survey Call Script - Spanish
29b. Household survey call script-Spanish.docx
No
Paper Only
Other-Appendix 37 Respondent Payment Log
37. Respondent Payment Log.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:
1,486
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
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
11,846
0
11,846
0
0
0
Annual IC Time Burden (Hours)
5,123
0
5,123
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Appendix 20.a Household Survey Advance Letter - English
20a. Household survey advance letter_English.docx
09/15/2017
Appendix 20.b Household Survey Advance Letter - Spanish
20b. Household survey advance letter_Spanish.docx
09/15/2017
Appendix 21.a Household Survey Brochure - English
21a. Household Survey Brochure (English).pdf
09/15/2017
Appendix 21.b Household Survey Brochure - Spanish
21b. Household Survey Brochure (Spanish).pdf
09/15/2017
Appendix 22.a Household Survey Frequently Asked Questions - English
22a. Household survey frequently asked questions (English).docx
09/15/2017
Appendix 22.b Household Survey Frequently Asked Questions - Spanish
22b. Household survey frequently asked questions (Spanish).docx
09/15/2017
Appendix 33.a Household Survey Thank You Letter - English
33a. Household Survey Thank you letter_English.docx
09/15/2017
Appendix 33.b Household Survey Thank You Letter - Spanish
33b. Household Survey Thank you letter_Spanish.docx
09/15/2017
Appendix 40.a Household Survey Door Hanger - English
40a. Household Survey Door Hanger (English).pdf
09/15/2017
Appendix 40.b Household Survey Door Hanger - Spanish
40b. Household Survey Door Hanger (Spanish).pdf
09/15/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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