View Information Collection (IC)
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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Respondents- Individuals/Households (Parents/Children/Teens)
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-G2. Household Eligibility Screener.docx
G2. Household Eligibility Screener.docx
www.notyetcreated.com
Yes
Yes
Fillable Fileable Signable
Other-G2.A Household Eligibility Screener web.docx
G2.A Household Eligibility Screener web.docx
www.notyetcreated.com
Yes
Yes
Fillable Fileable Signable
Other-G6. Telephone Follow-Up Script for Caregivers.docx
G6. Telephone Follow-Up Script for Caregivers.docx
No
Paper Only
Other-G7. Caregiver Survey.docx
G7. Caregiver Survey_2.16.18.docx
No
Paper Only
Other-G7.A Caregiver Survey web.docx
G7.A Caregiver Survey web.docx
www.notyetcreated.com
Yes
Yes
Fillable Fileable Signable
Other-G8. Child Participant Survey.docx
G8 Child survey.docx
No
Paper Only
Other-G8.A Child Participant Survey web.docx
G8.A Child Participant Survey web.docx
www.notyetcreated.com
Yes
Yes
Fillable Fileable Signable
Other-G9. Teen Survey.docx
G9. Teen Survey.docx
No
Paper Only
Other-G9.A Teen Survey web.docx
G9.A Teen Survey web.docx
www.notyetcreated.com
Yes
Yes
Fillable Fileable Signable
Other-G11. Telephone Script to Schedule Caregiver Key Informant Interview.docx
G11. Telephone Script to Schedule Caregiver Key Informant Interview.docx
No
Paper Only
Other-G12. Participant Caregiver KII Discussion Guide.docx
G12. Participant caregiver QI.docx
No
Paper Only
Other-G13. Nonparticipant caregiver QI.docx
G13. Nonparticipant caregiver QI.docx
No
Paper Only
Other-H7. Participant Caregiver Survey and Screener Pretest Protocol.docx
H7. Participant Caregiver Survey and Screener Pretest Protocol.docx
No
Paper Only
Other-H8. Nonparticipant Caregiver Survey and Screener Pretest Protocol.docx
H8. Nonparticipant Caregiver Survey and Screener Pretest Protocol.docx
No
Paper Only
Other-H9. Child Participant Survey Pretest Protocol.docx
H9. Child Participant Survey Pretest Protocol.docx
No
Paper Only
Other-H10. Teen Participant Survey Pretest Protocol.docx
H10. Teen Participant Survey Pretest Protocol.docx
No
Paper Only
Other-H11. Teen Nonparticipant Survey Pretest Protocol.docx
H11. Teen Nonparticipant Survey Pretest Protocol.docx
No
Paper Only
Other-H12. Participant Caregiver Key Informant Interview Pretest Protocol.docx
H12. Participant Caregiver Key Informant Interview Pretest Protocol.docx
No
Paper Only
Other-H13. Nonparticipant Caregiver Key Informant Interview Pretest Protocol.docx
H13. Nonparticipant Caregiver Key Informant Interview Pretest Protocol.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:
24,568
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
80 %
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
230,855
0
230,855
0
0
0
Annual IC Time Burden (Hours)
16,504
0
16,504
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
G1. Household Screener Invitation Letter.docx
G1. Household Screener Invitation Letter.docx
11/17/2017
G3. Invitation Letter for Mailed Surveys.docx
G3. Invitation Letter for Mailed Surveys.docx
11/17/2017
G4. Reminder Postcard to Eligible Caregivers.docx
G4. Reminder Postcard to Eligible Caregivers.docx
11/17/2017
G5. Invitation letter to onsite participants.docx
G5. Invitation letter to onsite participants.docx
11/17/2017
G10. Study Thank You With Incentives (All Caregivers).docx
G10. Study Thank You With Incentives (All Caregivers).docx
11/17/2017
G14. Key Informant Interview Thank You with Incentive (Caregivers).docx
G14. Key Informant Interview Thank You with Incentive (Caregivers).docx
11/17/2017
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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