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View Information Collection (IC)

Current, Former, and Recently Denied WIC Participants (Individuals/Households)
 
No New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Appendix B3.a Certification Survey Version A (Adult) - English Yes Yes Fillable Fileable
Other-Appendix B3.b Ceritfication Survey Version B (Infant/Child) - English Yes Yes Fillable Fileable
Other-Appendix B3.c Certification Survey Version A (Adult) - Spanish Yes Yes Fillable Fileable
Other-Appendix B3.d Certification Survey Version B (Infant/Child) - Spanish Yes Yes Fillable Fileable
Other-Appendix B4.a Denied Applicant Survey Version A (Adult) - English Yes Yes Fillable Fileable
Other-Appendix B4.b Denied Applicant Survey Version B (Infant/Child) - English Yes Yes Fillable Fileable
Other-Appendix B4.c Denied Applicant Survey: Version A (Adult) - Spanish Yes Yes Fillable Fileable
Other-Appendix B4.d Denied Applicant Survey Version B (Infant/Child) - Spanish Yes Yes Fillable Fileable
Other-Appendix B5.a Program Experiences Survey Version A (Adult) - English Yes Yes Fillable Fileable
Other-Appendix B5.b Program Experiences Survey Version B (Infant/Child) - English Yes Yes Fillable Fileable
Other-Appendix B5.c Program Experiences Survey Version A (Adult) - Spanish Yes Yes Fillable Fileable
Other-Appendix B5.d Program Experiences Survey Version B (Infant/Child) - Spanish Yes Yes Fillable Fileable
Other-Appendix B6.a Former WIC Participant Case Study Interview Guide - English No   Paper Only
Other-Appendix B6.b Former WIC Participant Case Study Interview Guide - Spanish No   Paper Only
Other-Appendix C11.a Certifcation Survey Recruitment Telephone Script - English Yes Yes Fillable Fileable
Other-Appendix C11.b Certification Survey Recruitment Telephone Script - Spanish Yes Yes Fillable Fileable
Other-Appendix C12.a Certification Survey recruitment In-Person Script - English No   Paper Only
Other-Appendix C12.b Certification Survey Recruitment In-Person Script - Spanish No   Paper Only
Other-Appendix C14.a Telephone Reminder for Scheduled Certification Survey - English Yes Yes Fillable Fileable
Other-Appendix C14.b Telephone Reminder for Scheduled Certification Survey - Spanish Yes Yes Fillable Fileable
Other-Appendix C15.a Denied WIC Applicant Survey Recruitment Telephone Script - English Yes Yes Fillable Fileable
Other-Appendix C15.b Denied WIC Applicant Survey Recruitment Telephone Script - Spanish Yes Yes Fillable Fileable
Other-Appendix C16.a Denied WIC Applicant Survey Recruitment In-Person Script - English No   Paper Only
Other-Appendix C16.b Denied WIC Applicant Survey Recruitment In-Person Script - Spanish No   Paper Only
Other-Appendix C18.a Telephone Reminder for Scheduled Denied Applicant Survey - English Yes Yes Fillable Fileable
Other-Appendix C18.b Telephone Reminder for Scheduled Denied Applicant Survey - Spanish Yes Yes Fillable Fileable
Other-Appendix C19.a Program Experiences Survey Invitation Telephone Script - English Yes Yes Fillable Fileable
Other-Appendix C19.b Program Experiences Survey Invitation Telephone Script - Spanish Yes Yes Fillable Fileable
Other-Appendix C22.a Program Experiences Survey Invitaton In-Person Script - English No   Paper Only
Other-Appendix C22.b Program Experiences Survey Invitation In-Person Script - Spanish No   Paper Only
Other-Appendix C23.a Former WIC Participant Case Study Interview Invitation Telephone Script - English Yes Yes Fillable Fileable
Other-Appendix C23.b Former WIC Participant Case Study Interview Invitation Telephone Script - Spanish Yes Yes Fillable Fileable
Other-Appendix D7.a Participant Consent Form - Certification Survey - English No   Paper Only
Other-Appendix D7.b Participant Consent Form - Certification Survey-Spanish No   Paper Only
Other-Appendix D9.a Participant Consent Form - Denied Applicant Survey - English No   Paper Only
Other-Appendix D9.b Participant Consent Form - Denied Applicant Survey - Spanish No   Paper Only

Income Security Food and Nutrition Assistance

FNS-8 USDA/FNS Studies and Reports  56 FR 19078

3,475 0
   
Individuals or Households
 
   57 %

  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 16,727 0 16,727 0 0 0
Annual IC Time Burden (Hours) 3,474 0 3,474 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Appendix C13.a Text Message Reminder for Scheduled Certification Survey - English 01/30/2018
Appendix C13.b Text Message Reminder for Scheduled Certification Survey - Spanish 01/30/2018
Appendix C17.a Text Message Reminder for Scheduled Denied Applicant Survey - English 01/30/2018
Appendix C17.b Text Message Reminder for Scheduled Denied Applicant Survey - Spanish 01/30/2018
Appendix C20.a Program Experiences Survey Invitation Letter - English 01/30/2018
Appendix C20.b Program Experiences Survey Invitation Letter - Spanish 01/30/2018
Appendix C21.a Program Experiences Survey Invitation Email - English 01/30/2018
Appendix C21.b Program Experiences Survey Invitation Email - Spanish 01/30/2018
Appendix D6.a Certification Survey Information Letter from State Agencies - English 01/30/2018
Appendix D6.b Certification Survey Information Letter from State Agencies - Spanish 01/30/2018
Appendix D8.a Denied WIC Applicant Information Letter from State Agencies - English 01/30/2018
Appendix D8.b Denied WIC Applicant Information Letter from State Agencies - Spanish 01/30/2018
Appendix D10.a Program Experiences Survey Invitation Postcard - English 01/31/2018
Appendix D10.b Program Experiences Survey Invitation Postcard - Spanish 01/31/2018
Appendix D11.a Participant Information Brochure - English 01/31/2018
Appendix D11.b Participant Information Brochure - Spanish 01/31/2018
Appendix D12.a Program Experiences Servey Thank You Letter and Visa Debit Card - English 01/31/2018
Appendix D12.b Program Experiences Survey Thank You Letter and Visa Debit Card - Spanish 01/31/2018
Appendix D13.a Former WIC Participant Case Study Interview Thank You Letter and Visa Debit Card - English 01/31/2018
Appendix D13.b Former WIC Participant Case Study Interview Thank You Letter and Visa Debit Card - Spanish 01/31/2018
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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