View Information Collection (IC)
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Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Respondents Individuals/Households - Elderly 60+
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
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-Attachment H.1_Elderly Participant Interview Guide.docx
Attch H.1_Elderly Participant Interview Guide.docx
No
Paper Only
Other-Attachment H.1.a_Elderly Participant Interview Guide_Spanish.docx
Attch H.1.a_Elderly Participant Interview Guide_Spanish.docx
No
Paper Only
Other-Attachment H.2_Elderly Participant Focus Group Guide.docx
Attch H.2_Elderly Participant Focus Group Guide.docx
No
Paper Only
Other-Attch D.5_Interview Screen Form 10-16-17.docx
Attch D.5_Interview Screen Form.docx
No
Paper Only
Other-Attachment D.5.a Int Screen Form_Spanish.docx
Attch D.5.a Int Screen Form_Spanish 10-16-17.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-9 STARS
FR Citation:
75 FR 81207
Number of Respondents:
366
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
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
566
0
566
0
0
0
Annual IC Time Burden (Hours)
395
0
395
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Attachment D.2_Int Recruitment Flyer 9-13-17.docx
Attch D.2_Int Recruitment Flyer 9-13-17.docx
09/28/2017
Attachment D.2.a_Int Flyer_Spanish 9-13-17.docx
Attch D.2.a_Int Flyer_Spanish 9-13-17.docx
09/28/2017
Attch D.3_Recruit Script 10-16-17.docx
Attch D.3_Recruit Script 10-16-17.docx
10/16/2017
Attch D.3.a_Recruit Script_Spanish 10-16-17.docx
Attch D.3.a_Recruit Script_Spanish 10-16-17.docx
10/16/2017
Attachment D.4_Focus Recruitment Flyer 9-13-17.docx
Attch D.4_Focus Recruitment Flyer 9-13-17.docx
09/28/2017
Attachment D.6_Interview Consent Form 9-13-17.docx
Attch D.6_Interview Consent Form 9-13-17.docx
09/28/2017
Attachment D.6a_Int Consent Form_Spanish 9-13-17.docx
Attch D.6a_Int Consent Form_Spanish 9-13-17.docx
09/28/2017
Attachment D.7_Focus Consent Form.docx
Attch D.7_Focus Consent Form.docx
09/28/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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